-
- Khalid Al-Ansari, Andrew Howard, Brian Seeto, Solina Yoo, Salma Zaki, and Kathy Boutis.
- Division of Emergency Medicine, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
- Can J Emerg Med. 2007 Jan 1;9(1):9-15.
BackgroundEmergency department (ED) manipulation of complete minimally angulated distal radius fractures in children may not be necessary, due to the excellent remodeling potential of these fractures.ObjectivesThe primary objective of this study was to determine the proportion of minimally angulated distal radius fractures managed in the ED with plaster immobilization that subsequently required manipulation. Our secondary objective was to document, at follow-up, changes in angulation for each wrist fracture.MethodsThis retrospective cohort study reviewed consecutive records of all children with bi-cortical minimally angulated (=15 degrees of angulation in the sagittal plane and =0.5 cm of displacement) distal metaphyseal radius fractures, alone or in combination with distal ulnar fracture. Details of treatment, radiographic findings, and clinical outcomes during the subsequent orthopedic follow up were recorded.ResultsOf 124 patients included in the analysis, none required manipulation after their ED visit. All but 14 (11.3%) fractures were angulated =20 degrees within the follow-up period. Two (1.6%) fractures that were initially angulated =15 degrees progressed to 30 degrees -35 degrees , but remodeled within 2 years to nearly perfect anatomic alignment. By 6 weeks post-injury, no patients had clinically apparent deformity and all had normal function.ConclusionsMinimally angulated fractures of the distal metaphyseal radius managed in plaster immobilization without reduction in the ED are unlikely to require future surgical intervention.
Notes
Knowledge, pearl, summary or comment to share?You can also include formatting, links, images and footnotes in your notes
- Simple formatting can be added to notes, such as
*italics*
,_underline_
or**bold**
. - Superscript can be denoted by
<sup>text</sup>
and subscript<sub>text</sub>
. - Numbered or bulleted lists can be created using either numbered lines
1. 2. 3.
, hyphens-
or asterisks*
. - Links can be included with:
[my link to pubmed](http://pubmed.com)
- Images can be included with:

- For footnotes use
[^1](This is a footnote.)
inline. - Or use an inline reference
[^1]
to refer to a longer footnote elseweher in the document[^1]: This is a long footnote.
.