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Position of Immobilization for Pediatric Forearm Fractures

Boyer, Bryan A. M.D.*; Overton, Brent M.D.; Schrader, William M.D.; Riley, Patrick M.D.; Fleissner, Paul M.D.

Journal of Pediatric Orthopaedics: March-April 2002 - Volume 22 - Issue 2 - p 185-187

The purpose of this study was to evaluate the effect of forearm position on residual fracture angulation for pediatric distal-third forearm fractures at the time of union. One hundred nine pediatric distal-third forearm fractures undergoing closed reduction and casting were prospectively randomized to be immobilized in pronated, supinated, or neutral position. Initial angulation and displacements were radiographically compared with healed fracture angulation at a minimum of 6 weeks. With 99 complete patient files, 38 fractures were casted in neutral, 26 in pronated, and 35 in supinated positions. Average initial angulation was 20°; postreduction angulation measured 3°. Final angulation at union averaged 7° for all fractures. Forearm position failed to show a significant effect on fracture angulation at union. Residual fracture angulation at the time of union for pediatric distal-third forearm fractures was not significantly affected by forearm position (pronation, supination, neutral) during cast immobilization.

Study conducted at Children's Hospital Medical Center of Akron, Akron, Ohio, U.S.A.

From *Grant Medical Center, Columbus, Ohio; †Steindler Orthopedic Clinic, Iowa City, Iowa; and ‡Children's Hospital Medical Center of Akron, Akron, Ohio, U.S.A.

Address correspondence and reprint requests to William Schrader, M.D., 300 Locust Street, Suite 170, Akron, OH 44302, U.S.A.

© 2002 Lippincott Williams & Wilkins, Inc.