Minimally angulated pediatric wrist fractures: is immobilization without manipulation enough?
| Autor: | Solina Yoo, Kathy Boutis, Andrew W. Howard, Brian L Seeto, Khalid Al-Ansari, Salma Zaki |
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| Rok vydání: | 2007 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Wrist Cohort Studies Immobilization Deformity medicine Humans Displacement (orthopedic surgery) Range of Motion Articular Child Reduction (orthopedic surgery) Retrospective Studies business.industry Ulna Fractures Sagittal plane Surgery Splints Casts Surgical medicine.anatomical_structure Treatment Outcome Orthopedic surgery Emergency Medicine Manipulation Orthopedic Female medicine.symptom business Range of motion Emergency Service Hospital Radius Fractures Follow-Up Studies |
| Zdroj: | Scopus-Elsevier |
| ISSN: | 1481-8035 |
| Popis: | Background: Emergency department (ED) manipulation of complete minimally angulated distal radius fractures in children may not be necessary, due to the excellent remodeling potential of these fractures. Objectives: The primary objective of this study was to determine the proportion of minimally angulated distal radius fractures managed in the ED with plaster immobilization that subsequently required manipulation. Our secondary objective was to document, at follow-up, changes in angulation for each wrist fracture. Methods: This retrospective cohort study reviewed consecutive records of all children with bi-cortical minimally angulated (≤15° of angulation in the sagittal plane and ≤0.5 cm of displacement) distal metaphyseal radius fractures, alone or in combination with distal ulnar fracture. Details of treatment, radiographic findings, and clinical outcomes during the subsequent orthopedic follow up were recorded. Results: Of 124 patients included in the analysis, none required manipulation after their ED visit. All but 14 (11.3%) fractures were angulated ≤20° within the follow-up period. Two (1.6%) fractures that were initially angulated ≤15° progressed to 30°–35°, but remodeled within 2 years to nearly perfect anatomic alignment. By 6 weeks post-injury, no patients had clinically apparent deformity and all had normal function. Conclusions: Minimally angulated fractures of the distal metaphyseal radius managed in plaster immobilization without reduction in the ED are unlikely to require future surgical intervention. |
| Databáze: | OpenAIRE |
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