Pediatric forearm shaft 22r-D/5

Closed reduction; cast or splint fixation

Closed reduction; cast or splint fixation

Main indication: Closed manipulation of simple fractures producing stable reduction (minimally displaced and angulated) possible

Skill: Some specialized surgical experience
Equipment: Basic equipment only

Simple oblique fractures are inherently unstable.

A well-molded cast and radiographic follow-up are recommended to ensure maintenance of satisfactory fracture position. If acceptable position cannot be obtained and maintained, operative stabilization should be considered.

Single bone fractures may be difficult to align by cast wedging.

Contraindications

  • Residual angulation more than the age-related modeling capacity
  • Residual displacement more than 50% of the shaft diameter in older children
  • Multifragmentary fractures

Advantages 

  • No requirement for implant removal

Disadvantages

  • High risk of displacement requiring additional general anesthetic and treatment
  • Single bone fracture may be difficult to reduce and stabilize.

Legend

*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

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v1.0 2018-11-28