Pediatric distal forearm 23-M/3.1

Open reduction; K-wire fixation

Open reduction; K-wire fixation

Main indication: Failure of closed reduction with residual angulation >15°, or complete displacement, certainly over the age of 10 years (Crawford)

Skill: Some specialized surgical experience
Equipment: Simple surgical and imaging resources

Advantages

  • Allows removal of interposed tissues
  • Allows direct reduction of fractures

Disadvantages

  • Requires skilled practitioner and full surgical facilities
  • Risk of soft tissue compression if cast is not split
  • Risk of pin-track problems and need for removal

Crawford SN, Lee LS, Izuka BH. Closed treatment of overriding distal radial fractures without reduction in children. J Bone Joint Surg Am. 2012 Feb 1;94(3):246-252.

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 2016-12-01