Site Map

Fractures of the forearm and wrist of the child

| Share

Forearm (radius and ulna shaft)

The main complication of these fractures is impaired forearm rotation (pronation: turn the palm downward; supination: turn the palm up). The radius turns around the ulna: therefore,moderate angulations may cause loss of forearm rotation.

These fractures have limited capacity of remodeling; hence, angles above 10-15 ° , according to age and location, are not acceptable.

Treatment depends on the degree of displacement and age:

  • Brachial circular plaster (stable fractures)
  • Elastic intramedullary needles of Metaizeau (Fig 21A)
  • Plate-screws (adolescents) (Fig. 21B)
     

CMI

Figure 21A
. Forearm bones fracture in a patient aged 9, treated surgically with elastic intramedullary needles.


CMI

Figure 21B
. Forearm bones fracture in a patient aged 14, fixed with plate and screws.


Fractures of the distal radius and ulna

  • Buckle fractures of the radius  (Fig 3)

Stable fracture. Both the forearm splint and the conventional bandage for 2-3 weeks are effective for pain control (antialgic action).

  • Metaphyseal fractures of the radius + / - ulna
  • The tolerable deformity depends on the age and the proximity of the fracture to the physis.
  • Closed reduction is performed under sedation, followed by immobilization in a brachial circular plaster for 4-6 weeks.
  • Remodeling capacity is 10 ° per year of growth (Fig 7A). If they are very unstable, they may require Kirschner wire fixation (Fig 21C).

CMI

Figure 21C
. Fracture of the distal radius and ulna, reduced in OR, and fixed with Kirschner wires.

In physeal fractures, given the high capacity of bone emodeling, reduction maneuvers are not recommended 10-14 days post-fracture, owing to the high risk of physeal damage (Fig 2).

In ulnar physeal fractures, there is a high incidence of premature physeal closure (30-50%), so they must be strictly controlled.
 

Scaphoid fractures   (Fig 22)  

Unlike adults, scaphoid fractures usually join without problems, and do not require surgical treatment. Cast immobilization is usually prolonged.

CMI

Figure 22
. Scaphoid fracture in an adolescent

Obstetric brachial palsy
Brachial Plexus Birth Palsy: Definition and Mechanisms of Injury:
Risk of brachial plexus birth palsy. Necessary diagnostic tests.
BPBP treatment: physical therapy and surgery
Shoulder problems in children with BPBP
Prevention and Risk of IRCS and DGH
Diagnosis and Treatment of Shoulder Dysplasia
What doctor does my baby need?
Clinical experience of Dr Soldado
Malformations
Short or absent thumb: thumb hypoplasia
Deviated wrist: radial and ulnar clubhand
Short fingers: Brachydactyly, symbrachydactyly, amniotic band syndrome
Less fingers: cleft hand and ulnar clubhand
Extra fingers or thumb: Polydactyly
Glued fingers or syndactyly
Cerebral Palsy
Definition, overview and assessment of cerebral palsy
Upper extremity problems in children with spastic hemiparesis
Nonsurgical treatment of spastic hemiparesis
The upper extremity in cerebral palsy with spastic tetraparesis
Surgical treatment of spastic hemiparesis
Microsurgery
Pediatric vascular microsurgery: overview
Bone loss reconstruction I: Vascularized fibula transfer
Bone loss reconstruction II: Periosteum transfer of vascularized fibula
Bone recalcitrant nonunion or pseudoarthrosis
Bone revascularization (osteonecrosis, aseptic necrosis)
Joint reconstruction. Transfer of epiphysis and growth plate of the vascularized fibula
Reimplantation and revascularization
Functional muscle transfer (vascularized and innervated)
Skin loss coverage
Fractures/Injuries
Overview of fractures
Typical bone fractures in children
Treatment of fractures in children: overview
Classification and treatment of physeal fractures
Fractures of the shoulder girdle, shoulder and arm of the child
Elbow fractures of the child
Fractures of the forearm and wrist of the child
Hand fractures in children
Upper extremity injuries of the child
Francisco Soldado
Doctor Francisco Soldado Videos
CV
Publications
Research Support
Known cases like yours
Cooperación internacional: Misiones quirúrgicas
Medical Links
© 2001-2015 Francisco SoldadoPrivacy PolicyLegal NoticeQuality Policy Website by