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Clinical Follow-Up without Radiographs Is Sufficient after Most Nonoperatively Treated Distal Radius Fractures in Children

Distal forearm fractures are common in children and are usually treated nonoperatively. No consensus has been reached on how to perform clinical and radiographic follow-up of these fractures. Our aim was to study whether radiographic and clinical follow-up is justified. We included 100 consecutive p...

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Autores principales: Perhomaa, Marja, Stöckell, Markus, Pokka, Tytti, Lieber, Justus, Niinimäki, Jaakko, Sinikumpu, Juha-Jaakko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9955157/
https://www.ncbi.nlm.nih.gov/pubmed/36832469
http://dx.doi.org/10.3390/children10020339
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author Perhomaa, Marja
Stöckell, Markus
Pokka, Tytti
Lieber, Justus
Niinimäki, Jaakko
Sinikumpu, Juha-Jaakko
author_facet Perhomaa, Marja
Stöckell, Markus
Pokka, Tytti
Lieber, Justus
Niinimäki, Jaakko
Sinikumpu, Juha-Jaakko
author_sort Perhomaa, Marja
collection PubMed
description Distal forearm fractures are common in children and are usually treated nonoperatively. No consensus has been reached on how to perform clinical and radiographic follow-up of these fractures. Our aim was to study whether radiographic and clinical follow-up is justified. We included 100 consecutive patients with non-operatively treated distal forearm fractures who were treated at Oulu University Hospital in 2010–2011. The natural history of the fractures during the nonoperative treatment was analyzed by measuring the potential worsening of the alignment during the follow-up period. The limits of acceptable fracture position were set according to the current literature using “strict” or “wide” criteria for alignment. We determined the rate of worsening fracture position (i.e., patients who reached the threshold of unacceptable alignment). In relation to splinting, we evaluated how many patients benefited from clinical follow-up. Most of the fractures (98%) preserved acceptable alignment during the entire follow-up period when wide criteria were used. The application of stricter criteria for alignment in radiographs showed loss of reduction in 19% of the fractures. Worsening of the alignment was recognized at a mean of 13 days (range 5–29) after the injury. One in three (32%) patients needed some intervention due to splint loosening or failure. Radiographic follow-up of nonoperatively treated distal forearm fractures remains questionable. Instead, clinical follow-up is important, as 32% of patients needed their splints fixed.
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spelling pubmed-99551572023-02-25 Clinical Follow-Up without Radiographs Is Sufficient after Most Nonoperatively Treated Distal Radius Fractures in Children Perhomaa, Marja Stöckell, Markus Pokka, Tytti Lieber, Justus Niinimäki, Jaakko Sinikumpu, Juha-Jaakko Children (Basel) Article Distal forearm fractures are common in children and are usually treated nonoperatively. No consensus has been reached on how to perform clinical and radiographic follow-up of these fractures. Our aim was to study whether radiographic and clinical follow-up is justified. We included 100 consecutive patients with non-operatively treated distal forearm fractures who were treated at Oulu University Hospital in 2010–2011. The natural history of the fractures during the nonoperative treatment was analyzed by measuring the potential worsening of the alignment during the follow-up period. The limits of acceptable fracture position were set according to the current literature using “strict” or “wide” criteria for alignment. We determined the rate of worsening fracture position (i.e., patients who reached the threshold of unacceptable alignment). In relation to splinting, we evaluated how many patients benefited from clinical follow-up. Most of the fractures (98%) preserved acceptable alignment during the entire follow-up period when wide criteria were used. The application of stricter criteria for alignment in radiographs showed loss of reduction in 19% of the fractures. Worsening of the alignment was recognized at a mean of 13 days (range 5–29) after the injury. One in three (32%) patients needed some intervention due to splint loosening or failure. Radiographic follow-up of nonoperatively treated distal forearm fractures remains questionable. Instead, clinical follow-up is important, as 32% of patients needed their splints fixed. MDPI 2023-02-09 /pmc/articles/PMC9955157/ /pubmed/36832469 http://dx.doi.org/10.3390/children10020339 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Perhomaa, Marja
Stöckell, Markus
Pokka, Tytti
Lieber, Justus
Niinimäki, Jaakko
Sinikumpu, Juha-Jaakko
Clinical Follow-Up without Radiographs Is Sufficient after Most Nonoperatively Treated Distal Radius Fractures in Children
title Clinical Follow-Up without Radiographs Is Sufficient after Most Nonoperatively Treated Distal Radius Fractures in Children
title_full Clinical Follow-Up without Radiographs Is Sufficient after Most Nonoperatively Treated Distal Radius Fractures in Children
title_fullStr Clinical Follow-Up without Radiographs Is Sufficient after Most Nonoperatively Treated Distal Radius Fractures in Children
title_full_unstemmed Clinical Follow-Up without Radiographs Is Sufficient after Most Nonoperatively Treated Distal Radius Fractures in Children
title_short Clinical Follow-Up without Radiographs Is Sufficient after Most Nonoperatively Treated Distal Radius Fractures in Children
title_sort clinical follow-up without radiographs is sufficient after most nonoperatively treated distal radius fractures in children
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9955157/
https://www.ncbi.nlm.nih.gov/pubmed/36832469
http://dx.doi.org/10.3390/children10020339
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