Pediatric Fractures of the Hand, Wrist, Forearm, and Elbow-Case: Distal Radius Fractures

Case: Distal Radius Fractures

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This document discusses distal radius fractures in children, specifically focusing on a case of an 11-year-old male with a distal third radius fracture and an intact ulna fracture. The patient underwent closed reduction and casting, but at 10 days post-reduction, there was poor cast index and clear loss of reduction. Therefore, closed reduction and percutaneous pinning (CRPP) was indicated using the Kapandji technique, which successfully reduced the fracture. <br /><br />The document emphasizes that distal radius fractures with an intact ulna are notoriously unstable and require close monitoring. It also notes that acceptable alignment for fractures after closed reduction is a controversial topic, with generally less angulation accepted for older patients and more proximal fractures. <br /><br />Treatment options for distal radius fractures include nonsurgical treatment with immobilization in a short-arm or long-arm cast and surgical fixation depending on the patient's age and the location and morphology of the fracture. Absolute surgical indications include open fractures, neurovascular compromise, irreducible fractures with unacceptable residual alignment, and unstable fractures that fail closed reduction and casting. <br /><br />Three-month follow-up radiographs showed good remodeling of the fracture, indicating successful treatment. <br /><br />In summary, distal radius fractures with an intact ulna in children are common and potentially unstable. Treatment options range from nonsurgical immobilization to surgical fixation, depending on the specific case. Acceptable alignment after closed reduction is a subject of debate. Close monitoring and appropriate intervention are necessary to achieve successful outcomes in these fractures.

Keywords

distal radius fractures

children

closed reduction

casting

surgical fixation

fracture stability

monitoring

acceptable alignment

treatment options

follow-up radiographs