Paediatric forearm fractures: Functional outcome of conservative treatment

Background: Forearm fractures are common in the paediatric age group. Closed reduction and casting are the primary means of treatment in over 90 % of these fractures. Resultant deformities are usually a product of indirect trauma involving angular loading combined with rotational deformity and fragment displacement. Materials and methods: Retrospectively, 48 patients aged between 4 to 12 years with forearm fractures, were treated conservatively with closed reduction and a cast during a 2-year period. Functional outcomes were measured in terms of pronation and supination. Results: All fractures united before the final visit. Most forearm bone fractures were complete fractures at the mid shaft. Eighty-six percent of the patients had excellent functional outcomes and none had poor outcomes. There were significantly reduced angles of deformities before and after treatment (p<0.05). Radiographically, in the frontal plane, 57.1 % of radius and 73.9 % of ulnar fractures achieved perfect reduction (i.e. a degree of deformity of less than 5°). However, in the lateral plane, there were fewer perfect reductions for the radius and ulna, at 14.6 % and 54.3 %, respectively. All except for one patient were satisfied with the outcomes. The level of fracture did not influence the outcomes. Conclusion: Conservative treatment is still an acceptable form of treatment especially for stable forearm fractures in children achieving excellent outcomes.