Retention of forearm plates: risks and benefits in a paediatric population.
Most surgeons favour removing forearm plates in children. There is, however, no long-term data regarding the complications of retaining a plate. We present a prospective case series of 82 paediatric patients who underwent plating of their forearm fracture over an eight-year period with a minimum follow-up of two years. The study institution does not routinely remove forearm plates. A total of 116 plates were used: 79 one-third tubular plates and 37 dynamic compression plates (DCP). There were 12 complications: six plates (7.3%) were removed for pain or stiffness and there were six (7.3%) implant-related fractures. Overall, survival of the plates was 85% at 10 years. Cox regression analysis identified radial plates (odds ratio (OR) 4.4, p = 0.03) and DCP fixation (OR 3.2, p = 0.02) to be independent risk factors of an implant-related fracture. In contrast ulnar plates were more likely to cause pain or irritation necessitating removal (OR 5.6, p = 0.04). The complications associated with retaining a plate are different, but do not occur more frequently than the complications following removal of a plate in children.
The Royal Hospital for Sick Children, 9 Sciennes Road, Edinburgh EH9 1LF, UK. nickclement@doctors.org.uk
N D
ND
Clement
F
F
Yousif
A D
AD
Duckworth
K H
KH
Teoh
D E
DE
Porter
D000293:Adolescent; D000367:Age Factors; D001860:Bone Plates / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D020878:Device Removal; D004812:Epidemiologic Methods; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D008297:Male; D057068:Periprosthetic Fractures / Q000209:etiology; D011885:Radius Fractures / Q000601:surgery*; D012737:Sex Factors; D014458:Ulna Fractures / Q000601:surgery*