Characteristics of forearm refracture in adolescents.

Autor:	Kapadia AB; Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center., Wilson PL; Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center.; Department of Orthopaedics and Sports Medicine, Scottish Rite for Children.; Division of Sports Medicine, Children's Medical Center Dallas, Dallas, Texas, USA., Gill CS; Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center.; Department of Orthopaedics and Sports Medicine, Scottish Rite for Children.; Division of Sports Medicine, Children's Medical Center Dallas, Dallas, Texas, USA., Wyatt CW; Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center.; Department of Orthopaedics and Sports Medicine, Scottish Rite for Children., Montgomery GK; Department of Orthopaedics and Sports Medicine, Scottish Rite for Children., Huang SG; Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center., Ellis HB Jr; Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center.; Department of Orthopaedics and Sports Medicine, Scottish Rite for Children.; Division of Sports Medicine, Children's Medical Center Dallas, Dallas, Texas, USA.
Jazyk:	angličtina
Zdroj:	Journal of pediatric orthopedics. Part B [J Pediatr Orthop B] 2024 Jan 01; Vol. 33 (1), pp. 58-64. Date of Electronic Publication: 2023 Feb 08.
DOI:	10.1097/BPB.0000000000001057
Abstrakt:	The purpose of this study was to evaluate characteristics of reinjury following forearm fractures in adolescents. An Institutional Review Board-approved retrospective cohort study of forearm fractures (ages 10-18 years) treated by a single academic pediatric orthopaedic group from June 2009 to May 2020 was conducted. All both bone forearm (BBFA) and radius or ulna primary and secondary injuries were included. We excluded open, surgically treated, physeal, epiphyseal, and radial head/neck fractures. Demographics, injury characteristics, and radiographic data were recorded. We evaluated associations of ipsilateral same-site refracture (RE-FRACTURE) versus ipsilateral or contralateral different-site forearm fractures occurring as secondary later injuries (OTHER). Thirty-three of 719 patients sustained a secondary forearm fracture (4.6%; mean age, 11.5 years; M:F, 5.6:1). RE-FRACTURES, compared with OTHER forearm locations, were associated with a sports mechanism at time of original injury ( P = 0.024) and mid-shaft position of fracture on the radius (77.6 vs. 29.8 mm from distal physis; P < 0.001) and ulna (72.0 vs. 27.2 mm from distal physis; P = 0.003). RE-FRACTURES also demonstrated increased radius to ulna distance between BBFA primary injury sites on anteroposterior (19.6 vs. 10.6 mm; P = 0.009) and lateral radiographs (19.6 vs. 10.5 mm; P = 0.020) compared with OTHER forearm locations. Residual angulation and fracture-line visibility were not significantly associated with secondary fracture. Ipsilateral same-site refractures tend to occur in adolescents within 1 year following treatment for widely spaced (>15 mm) and mid-shaft forearm fractures incurred during athletic activity. Further research may be warranted to evaluate biologic, bone health, or personality traits that may lead to secondary fractures of the pediatric forearm. (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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