title: Factors affecting remanipulation in paediatric forearm fractures.
abstract: Children's forearm fractures treated in plaster after closed reduction can redisplace and require remanipulation. A retrospective review of 164 consecutive manipulations of fractures of radius and ulna in theatre over a 3-year period was carried out. After various exclusions, 114 patients entered the study. The overall rate of remanipulation was 14.04% (16 children). Presence of preoperative translation deformity predisposed to loss of position in plaster (P<0.0001). Residual deformity on intraoperative films also had a strong adverse influence on the outcome (P = 0.001). Usage of below-the-elbow plaster in distal fractures (P = 0.840), having a low cast index (P = 0.538), fracture of both radius and ulna (P = 0.248), site of the fracture (P = 0.048, not significant on logistic regression) or surgeon grade (P = 0.744) did not have any significant bearing on the rate of manipulation. We propose that fractures with preoperative translation where anatomical reduction is not achieved should be fixed internally.
authors.affiliation: Furness General Hospital, Barrow-in-Furness, Cumbria, UK. puneetmonga05@gmail.com
authors.forename: Puneet
authors.initials: P
authors.lastname: Monga
authors.forename: Anantakrishna
authors.initials: A
authors.lastname: Raghupathy
authors.forename: Nigel H
authors.initials: NH
authors.lastname: Courtman
mesh_terms: D002648:Child; D005260:Female; D056908:Foraminifera; D006801:Humans; D008297:Male; D008349:Manipulation, Orthopedic; D011885:Radius Fractures / Q000628:therapy*; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014458:Ulna Fractures / Q000628:therapy*