General Editor: Chris Colton

Authors: Fergal Monsell, Dalia Sepulveda

Pediatric distal forearm 23r-E/3.1

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Glossary

General considerations

This fracture requires a more precise assessment of the joint surface disruption (eg, ultrasonography, arthrography or MRI).

Note: No malalignment of the joint surface is acceptable.

It is possible to use nonoperative treatment for the management if totally undisplaced.

If anatomical reduction cannot be achieved, operative treatment is required.

Short or long arm cast
Main indication Skill Equipment
Undisplaced joint surface Basic surgical experience, no specialized skills Basic equipment only

Supporting indications

  • No major local soft tissue compromise

Advantages

  • Noninvasive and does not require full surgical resources

Disadvantages

  • Requires monitoring by additional imaging
Closed reduction; K-wire fixation
Main indication Skill Equipment
Articular displacement Some specialized surgical experience Simple surgical and imaging resources

Advantages

  • Prevents secondary displacement

Disadvantages

  • Risk of pin-track infection
  • Requires skilled practitioner
  • Requires monitoring by additional imaging
Open reduction; K-wire fixation
Main indication Skill Equipment
Irreducible articular disruption Some specialized surgical experience Simple surgical and imaging resources

Advantages

  • Allows direct anatomical reduction of the joint surface
  • Prevents secondary displacement

Disadvantages

  • Risk of pin-track infection
  • Requires skilled practitioner and full surgical resources
  • Requires monitoring by additional imaging
*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

v1.0 2016-12-01