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Atypical distal radial fractures in children

Kiely, Paul D.a; Kiely, Patrick J.b; Stephens, Micheal M.b; Dowling, Frank E.a

Journal of Pediatric Orthopaedics B: May 2004 - Volume 13 - Issue 3 - p 202-205

In a prospective study of paediatric injuries secondary to the use of the non-motorized microscooter, we found a high rate of upper limb trauma, and a distinct injury associated with the scooter. The most common single injury was a fracture of the distal third of radius and ulna, characterized by volar angulation of the distal fragment. This injury, akin to the Smiths fracture in adults, was predictive of scooter use in all cases. This pattern of injury was not repeated by any another mechanism of injury during the course of the study period. The mechanism of injury, seemingly specific to the scooter, is produced by a fall while continuing to clutch the handlebars, leading to palmar flexion and pronation of the wrist as they strike the ground. Fourteen children required admission and manipulation under anaesthesia. Four of these patients subsequently needed remanipulation under anaesthesia. This study suggests that the scooter is associated with a forearm fracture which is both distinctive and unstable.

aOur Lady's Hospital for Sick Children, Crumlin

bDepartment of Orthopaedic Surgery, The Children's Hospital, Temple Street Dublin, Ireland

Correspondence and requests for reprints to Mr Paul Kiely, Department of Trauma and Orthopaedic Surgery, AMNCH, Tallaght, Dublin 24, Ireland

Tel: +353 1 4142000; fax: +353 1 4144779;


© 2004 Lippincott Williams & Wilkins, Inc.