![]() Single-bone forearm fractures of the radius or ulna raise the possibility of Monteggia or Galeazzi fracture dislocations. X-rays should be obtained between one and two weeks after initial reduction to detect early angulation.Ĭhildren’s bones are softer and more pliable than adults, resulting in different fractures. In all cases, bayonet apposition can be up to 1 centimeter. For older children, angulation should be less than 10 degrees proximal/midshaft and less than 15 degrees distal, with rotation less than 30 degrees. Generally accepted guidelines for pediatric both-bone forearm fractures recommend angulation less than 15 degrees and rotation less than 45 degrees for girls up to age 8 and boys up to age 10. Complete fractures are reduced with traction and rotation, and then immobilized with casting until healed. Greenstick fractures, which are more common in younger children, are reduced by rotating the forearm so the palm is directed toward the fracture apex. Most occur in the distal one third of the forearm. The force is transmitted initially to the radius, which fails first, then the ulna. Pediatric forearm fractures typically result from indirect trauma, such as a fall from a bicycle, tree or playground equipment onto an outstretched hand, coupled with a rotational displacement. To refer a patient, visit Norton EpicLink and open an order for Pediatric Orthopedics. Norton Children’s Orthopedics of Louisville ![]() They are more common in school-age children and adolescents compared with infants and preschool-age children. In half of forearm fractures, radius and ulna are both fractured, with both bone fractures occurring more frequently in boys than girls. Pediatric forearm fractures account for 17.8% of all fractures in children. Standard X-rays are usually enough to diagnose a forearm fracture. If a loss of reduction occurs after casting, a forearm fracture typically can be remanipulated for up to three weeks. A splint will not make the fracture worse.Ī split cast can be used for swelling on a pediatric forearm fracture. “It’s also important because it ensures the child receives care that promotes optimal healing of growing bones.”Ĭhildren can stay in a splint for seven to 10 days before needing to see a pediatric orthopedic provider. Bachman, M.D., pediatric orthopedic surgeon with Norton Children’s Orthopedics of Louisville, affiliated with the UofL School of Medicine. “It’s important that pediatric patients see a pediatric orthopedist so they are not in a cast longer than they need to be,” said Daniel R. Younger children heal faster, so the time in a cast should be limited to four to six weeks, while teens generally take six weeks to heal. Forearm fractures, one of the most common pediatric fractures, can be safely and effectively treated with cast immobilization.
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