Original articleCharacteristics of forearm refracture in adolescentsKapadia, Ami B.a; Wilson, Philip L.a,b,c; Gill, Corey S.a,b,c; Wyatt, Charles W.a,b; Montgomery, Gerad K.b; Huang, Sharon G.a; Ellis, Henry B. Jr.a,b,c Author Information aDepartment of Orthopaedic Surgery; University of Texas Southwestern Medical Center bDepartment of Orthopaedics and Sports Medicine, Scottish Rite for Children cDivision of Sports Medicine, Children’s Medical Center Dallas, Dallas, Texas, USA Received 25 February 2022 Accepted 26 December 2022. Correspondence to Henry B. Ellis, Jr., MD, Scottish Rite for Children, 2222 Welborn St, Dallas, TX 75219, USA, Tel: +(214) 559 5000; e-mail: [email protected] Journal of Pediatric Orthopaedics B ():10.1097/BPB.0000000000001057, January 19, 2023. | DOI: 10.1097/BPB.0000000000001057 Buy PAP Metrics Abstract 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 Wolters Kluwer Health, Inc. All rights reserved.