title: Redisplacement of diaphyseal fractures of the forearm after closed reduction in children: a retrospective analysis of risk factors.
abstract: OBJECTIVE
  Manipulation and plaster fixation is the primary management for diaphyseal fractures of the radius and/or ulna in children. This study was designed to evaluate risk factors of fracture redisplacement after closed reduction and cast immobilization.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Tertiary hospital.
  
  
  METHODS
  Fifty-seven children with fractures of the radius were included.
  
  
  METHODS
  The medical records of patients with/without ulna treated with closed reduction and casting were reviewed.
  
  
  METHODS
  Data analyzed were age, sex, dominant hand, fracture pattern, reduction quality, experience of the surgeon, and type of anesthesia. Logistic regression was used for multivariate analysis.
  
  
  RESULTS
  There were 41 (71.9%) males and 16 (28.1%) females with a mean age of 9.74 ± 3.07 years. There were 53 radius fractures and 54 ulna fractures, and 22 subjects experienced redisplacement. The redisplacement rate of radius fractures was 34% and of ulnar fractures was 27.8%. Multivariate analysis showed that the factors associated with redisplacement of radius fractures were fair reduction quality [odds ratio (OR), 8.45] and complete fracture (OR 9.62) and those for redisplacement of ulna fractures were fair reduction quality (OR 8.10) and complete fracture (OR 8.43).
  
  
  CONCLUSIONS
  Poorer reduction and complete fracture are more likely to result in redisplacement, and surgical management may be considered in these cases.
authors.affiliation: Department of Orthopedics, Tri-Service General Hospital, Taipei, Taiwan, Republic of China.
authors.forename: Jui-Jung
authors.initials: JJ
authors.lastname: Yang
authors.forename: Jen-Huei
authors.initials: JH
authors.lastname: Chang
authors.forename: Kun-Yi
authors.initials: KY
authors.lastname: Lin
authors.forename: Leou-Chyr
authors.initials: LC
authors.lastname: Lin
authors.forename: Chun-Lin
authors.initials: CL
authors.lastname: Kuo
mesh_terms: D000328:Adult; D000368:Aged; D002370:Casts, Surgical; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000706:statistics & numerical data*; D015995:Prevalence; D011885:Radius Fractures / Q000453:epidemiology* / Q000628:therapy*; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013624:Taiwan; D016896:Treatment Outcome; D014458:Ulna Fractures / Q000453:epidemiology* / Q000628:therapy*; D055815:Young Adult