The evolution of hand function during remodelling in nonreduced angulated paediatric forearm fractures: a prospective cohort study

Britt Barvelink, Joris Ploegmakers*, Arjan J. Harsevoort, Martin Stevens, Cees C. P. M. Verheyen, Ann Marjolein Hepping, Sjoerd K. Bulstra

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)
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Abstract

Forearm fractures are very common orthopaedic injuries in children. Most of these fractures are forgiving due to the unique and excellent remodelling capacity of the juvenile skeleton. However, significant evidence stating the limits of acceptable angulations and taking functional outcome into consideration is scarce. The aim of this study is, therefore, to get a first impression of the remodelling capacity in nonreduced paediatric forearm fractures based on radiological and functional outcome. Children aged 0-14 years with a traumatic angular deformation of the radius or both the radius and ulna, treated conservatively without reduction, were included in this prospective cohort study. Radiographs were taken and functional outcome was assessed at five fixed follow-up appointments throughout a period of one year. Outcome measurements comprised radiographic angular alignment, grip strength and wrist mobility. A total of 26 children (aged 3-13 years) with a traumatic angulation of the forearm were included. Mean dorsal angulation at the time of presentation amounted to 12° (5-18) and diminished after one year to a mean angulation of 4° (0-13). Grip strength, pronation and supination were significantly diminished compared to the unaffected hand up to 6 months after injury. After one year, no significant differences in function between the affected and the unaffected arm were found. Nonreduced angulated paediatric forearm fractures have the potential to remodel in time and have good radiographic and functional outcome one year after trauma, where pronation and grip strength take the longest to recover.

Original languageEnglish
Pages (from-to)172-178
Number of pages7
JournalJournal of Pediatric Orthopaedics. Part B
Volume29
Issue number2
Early online date18-Nov-2019
DOIs
Publication statusPublished - Mar-2020

Keywords

  • angulation
  • conservative treatment
  • functional outcome
  • grip strength
  • paediatric forearm fractures
  • remodelling
  • DISTAL RADIUS FRACTURES
  • RISK-FACTORS
  • EPIPHYSEAL GROWTH
  • RE-DISPLACEMENT
  • CHILDREN
  • BONE
  • MANAGEMENT
  • REDISPLACEMENT
  • EPIDEMIOLOGY
  • MALUNION

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