Factors affecting re-displacement in pediatric forearm fractures and the role of cast indices
Ender Alagöz, Mehmet Akif Güleç
Department of Orthopedics and Traumatology, University of Health Sciences Bağcılar Training and Research Hospital, Istanbul, Turkey
Keywords: Casting technique, displacement, forearm fracture, pediatrics
Objectives: This study aims to investigate the factors affecting the loss of reduction in pediatric diaphyseal forearm fractures and to compare the three-point index (TPI) with the cast index, padding index, Canterbury index, and gap index.
Patients and methods: This retrospective study, which was conducted between January 2016 and December 2016, included 159 patients (134 males, 25 females; mean age 8.1±2.8 years; range, 3 to 13 years) with diaphyseal forearm fracture. Patients’ age, gender, and the level, displacement, and location of the fractures were recorded. The presence of anatomic reduction, a straight ulnar border, and the cast type (banana or box type) were checked after the reduction. The TPI, cast index, padding index, Canterbury index, and gap index were measured.
Results: Fifty-two patients (32.7%) experienced loss of reduction during the follow-up. Displaced fractures of both the radius and the ulna, cast type-banana, anatomical reduction, straight ulnar border, TPI, cast index, padding index, and Canterbury index were found to be associated with re-displacement.
Conclusion: Although cast indices can be used as a beneficial clinical tool in predicting the loss of reduction in the treatment of pediatric forearm fractures, they may not be sufficient when used alone. Obtaining a more accurate result may be possible by assessing several parameters such as the presence of an anatomic reduction, box-type casting, and TPI together.
Citation: Alagöz E, Güleç MA. Factors affecting re-displacement in pediatric forearm fractures and the role of cast indices. Jt Dis Relat Surg 2020;31(1):95-101.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.