Single Bone Fixation versus Both Bone Fixation for Pediatric Unstable Forearm Fractures: A Systematic Review and Metaanalysis

BACKGROUND: It is uncertain whether single bone fixation is comparable to both bone fixation in the treatment of unstable both bone forearm fractures in children. MATERIALS AND METHODS: A systematic review using PubMed, Embase, and Cochrane Library database searches was performed on October 1, 2015 on English language scientific literature only. Clinical study designs comparing single bone fixation with both bone fixation of pediatric both bone forearm fractures were included. Studies of only one treatment modality were excluded from the study. Studies eligible for inclusion were assessed using the risk of bias tool for nonrandomized studies. RESULTS: Metaanalysis points to no significant differences in re-angulation, loss of rotation, union time and complications between single bone and both bone fixation. However, the published research lacks quality. CONCLUSIONS: Despite scattered evidence and small sample sizes, the metaanalysis suggests single bone fixation can be considered a suitable alternative for both bone forearm fractures in children, as it carries less time in surgery and less cost without compromise in final functional outcome compared to double-bone fixation.