Executive Editor: James Hunter General Editor: Fergal Monsell

Authors: Andrew Howard, Peter Schmittenbecher, Theddy Slongo

Pediatric proximal forearm 21r-M/2.1

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Glossary

General considerations

Conservative treatment (immobilization without reduction or fixation) is only recommended for minimally displaced, stable factures (type I) including torus and incomplete fractures.

The type of immobilization depends on age of the patient, the amount of pain and the compliance of the patient and carers.

Associated fractures of the olecranon or coronoid process or a Monteggia equivalent lesion should be excluded.

Sling immobilization
Main indication Skill Equipment
Compliant patient Basic surgical experience, no specialized skills Basic equipment only

Advantages

  • Comfortable
  • Good radiological access
  • Avoidance of joint stiffness
  • Early functional treatment

Disadvantages

  • Small risk of displacement
Cast immobilization
Main indication Skill Equipment
Uncompliant patient Basic surgical experience, no specialized skills Basic equipment only

Contraindications

  • Severe swelling
  • Severe pain
  • Skin lesions

Advantages

  • Cannot be removed by patient/parent

Disadvantages

  • Loss of x-ray definition
  • Joint stiffness
Splint immobilization
Main indication Skill Equipment
Uncompliant patient Basic surgical experience, no specialized skills Basic equipment only

Supporting indications

  • Swelling and pain
  • Skin lesions

Advantages

  • Removable for skin care
  • Removable if pain or neurovascular problems develop

Disadvantages

  • Small risk of displacement
*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 2019-08-28