Open fractures of the forearm in children.
OBJECTIVE
To describe the epidemiology, early results of treatment, and complications associated with open fractures of the forearm in children.


METHODS
Retrospective review of patients treated according to protocol.


METHODS
Level I trauma center.


METHODS
All children with an open fracture of the forearm during a four-year period (n = 76). Fourteen patients were excluded because of inadequate follow-up or incomplete medical records.


METHODS
All fractures were treated with irrigation and debridement, and parenteral antibiotics. Twenty-five patients were managed with cast immobilization only, and the remaining thirty-seven, with internal fixation either with transcutaneous pins, intramedullary pins, or plates and screws, followed by immobilization in a cast.


METHODS
Time to union, angular alignment at union, and incidence of complications.


RESULTS
The average time to union was 8.9 weeks (median, eight weeks; range, 6 to 17 weeks). There were no nonunions, but three of the sixty-two fractures had delayed union. Eight of the sixty-two fractures healed with an angular deformity of more than 10 degrees, and two developed infections, one deep and one superficial. There were three preoperative and four postoperative nerve palsies, which all resolved spontaneously.


CONCLUSIONS
Open fractures of the forearm in children, treated with prompt administration of parenteral antibiotics followed by debridement, were associated with a fairly low incidence of complications. Although we found that the use of some form of internal fixation tended to reduce both the need to remanipulate these fractures (p = 0.08), and to minimize the incidence of angular deformity greater than 10 degrees (p = 0.16), these findings did not reach statistical significance.
Women and Children's Hospital, Department of Orthopaedic Surgery, University of Southern California, Los Angeles 90033, USA.
B
B
Greenbaum
L E
LE
Zionts
E
E
Ebramzadeh
D000293:Adolescent; D017677:Age Distribution; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001134:Arm Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy*; D001858:Bone Nails; D002140:California / Q000453:epidemiology; D002370:Casts, Surgical; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods; D017102:Fracture Healing; D005597:Fractures, Open / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy*; D006801:Humans; D015994:Incidence; D008297:Male; D011336:Probability; D011379:Prognosis; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy; D012189:Retrospective Studies; D017678:Sex Distribution; D016896:Treatment Outcome; D014458:Ulna Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy
D000900:Anti-Bacterial Agents