![]() ![]() The SCARE statement: consensus-based surgical case report guidelines. Treatment of diaphyseal forearm fractures in children. Nonoperative treatment of both-bone forearm shaft fractures in children: predictors of early radiographic failure. The management of forearm fractures in children: a plea for conservatism. A 10-year study of the changes in the pattern and treatment of 6,493 fractures. Binary logistic regression analysis showed that open reduction was significantly more frequent in patients with subcondylar fracture compared to in those with a fracture in the condylar head area. Surgical exploration is recommended in cases of delayed recovery of nerve function.īoth-bone forearm case report fracture palsy pediatric peripheral nerve.Ĭheng JC, Ng BK, Ying SY, Lam PK. None of the patients underwent open reduction of condylar head fracture. Conclusion: The uncommon occurrence of ulnar nerve palsy after closed forearm fractures in children should alert physicians to maintain a high index of suspicion and to thoroughly evaluate nerve function in children both before and after reduction of forearm fractures. However, in both-bone forearm fractures, management began with observation, with surgical exploration being reserved for non-improving patients. These fractures are commonly managed conservatively by closed reduction, casting, and rehabilitation. We found 14 case reports in the literature with similar case presentations. The patient was admitted and underwent closed reduction with percutaneous elastic stable intramedullary nailing. ![]() On follow-up 7 days later, signs of ulnar nerve palsy in the form of decreased sensation in the little finger and weak abduction and adduction of the fingers were present. ![]() Examination at our ED revealed intact vascularity and nerve function. Case presentation: A 10-year-old boy presented to the emergency department (ED) 1 day after sustaining a closed right forearm fracture due to a fall. Furthermore, we explored how to best manage such cases and decrease permanent nerve damage through a literature review. Here, we present a case of ulnar nerve palsy complicating a closed both-bone forearm fracture in a pediatric patient. Identification of the type of nerve damage is vital for proper management of this complication. Nerve damage can be due to multiple factors. However, ulnar nerve palsy is a rare complication. Increased dorsal comminution may further compromise fracture stability, complicate surgery and have negative effect on the postoperative course.Ĭlosed reduction Distal radius fracture Dorsal comminution Manipulation.Background: Fractures of both the ulna and radius, known as both-bone forearm fractures are common among the pediatric population. Only 5.2% of patients who underwent two reduction attempts had an acceptable final alignment and did not require surgery. Of the 19 (25%) patients with acceptable alignments after two reduction attempts, follow-up radiographs were available for 12, which showed successful reduction in four cases (33.3 or 5.2% of total 76 patients).Ī second closed reduction attempt improved immediate fracture alignment, but also worsened dorsal comminution. Mean dorsal comminution length increased by 1.6 mm. Patients were also followed retrospectively to determine the rates of secondary displacement in a cast.Ī second closed reduction attempt improved mean radial height by 1.43 mm, mean radial inclination by 1.62° and mean volar tilt by 8.75°. Radiographs taken after the first and second reduction attempts were reviewed for changes in fracture alignment parameters (radial height, radial inclination, volar tilt) and dorsal comminution length. Seventy-six (12.3%) DRF who underwent two reductions were included in the study. Six-hundred-eighteen patients with DRF were treated in the medical center in 2007-2010. This retrospective cohort study has investigated the effect of second reduction attempt on fracture alignment and comminution. The additional manipulation of the fracture may, however, increase dorsal comminution and lead to loss of reduction in the cast. Repeated attempts of closed reduction of distal radius fractures (DRF) are performed in the emergency department setting to optimize fracture alignment and avoid surgery. ![]()
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