[Forearm fractures in children].

Abstract

Fractures of the forearm in children are quite frequent injuries, treated in emergency rooms. Most of them occur during leisure or sport activities. Most cases are monotraumatic. The diagnosis can be made by a conventional x-ray examination of the forearm in two planes. It is possible to differentiate between stable fractures (greenstick fractures) and unstable (dislocated) fractures. The first-line therapy for stable fractures or fractures which can be reduced anatomically correctly, is the conservative procedure using a long arm cast. Axial dislocation up to 20 degrees (age <5 years) or up to 10 degrees (age >5 years) can be accepted. Special cases, such as Monteggia or Galeazzi fractures, must be considered. Unstable fractures have to be reduced during surgical stand-by. The state of the art in surgical therapy is intramedullary nailing with titanium elastic nails. Open fractures and fractures with severe soft tissue injuries can be treated with external fixation. Osteosynthesis with plates should only be used for special indications. By following therapeutic principles, a successful outcome can be achieved and later complications are rare.