Evaluation of treatment of displaced diaphyseal fractures of the radius and ulna in children in Duhok emergency teaching hospital

الملخص EN

Background : Forearm fractures are extremely common in children, mostly in the distal third.

In most cases non-operative management results in a good outcome, but there are circumstances in which operative management is necessary to optimise union and maximize functional outcome.

Objectives : To report the outcomes of both conservative and operative methods of treatment of the forearm bone fractures in children.

Patients and methods : This is a retrospective study of 103 children with displaced diaphyseal fracture of radius and ulna treated at Duhok emergency teaching hospitals between December 2010 and December 20012, their ages ranged from 2.5-13years, majority were male & majority were treated conservatively.

For all patients presented with displaced fractures ; manipulation under general anesthesia was done with cast application, these were assessed radiologically, to be followed up for six months clinically and radiologically, if reduction is satisfactory, or else treated by open reduction and internal fixation if reduction is unsatisfactory, redisplaced, malaligned or became malunited later during the follow up.

Outcome was assessed later both clinically and radiologically.

Results : In 78 patients conservative treatment were successful because of few complications, shorter duration of hospitalization and better functional-outcome results.

The remaining 25 patients required operative treatment in which complications and period of hospital stay were longer and functional outcome was not as good as conservative treatment.

Conclusions : The majority of paediatric forearm fractures were caused by fall on outstretched hand and the majority were right handed in whom fractures occurred in the middle and distal third of the radius and ulna.

Both methods of treatment were useful in dealing with such fractures but relatively with different outcome.

Conservative treatment was safer, easier, with less complication, needs shorter period of hospitalization, and has better functional outcome.