Abstract
Purpose: To determine the need for routine serial radiographs in the management of forearm fractures in children.
Material and Methods: A binational study was conducted in 202 consecutive children with closed forearm fractures. In the 91 patients with stable fractures that did not require reduction, clinical and radiographic examination was performed one week after the start of treatment and again on cast removal 4–6 weeks later. In the remaining 111 patients who underwent closed reduction, an additional X-ray was taken two weeks after cast placement. Outcome was defined as the occurrence of redisplacement.
Results: Redisplacement occurred during the first 2 weeks of cast management in 9 of the children who required reduction and in none of the children who did not.
Conclusion: Radiographs should be performed one week after cast placement for greenstick or complete fractures that do not require reduction, and repeated at 2 weeks from start of treatment for fractures that require reduction. They need not be performed on cast removal, if clinical examination does not show signs of nonunion or malalignment. The adoption of these recommendations will lead to more cost-effective management and will spare children unnecessary radiographic exposure.
The abstracts were prepared by Ms Orah Naor. Correspondence should be addressed to Israel Orthopaedic Association at PO Box 7845, Haifa 31074, Israel.
