![]() ![]() The inclusion criteria were patients under 16 years old with distal fourth radius fractures confirmed by X-ray images. We retrospectively reviewed paediatric patients who underwent closed reduction and instant rigid cast immobilization for simple distal radius fractures in our hospital between February 2014 and March 2018. The aim is to record the incidence of redisplacement after closed reduction and instant rigid cast immobilization and to identify possible risk factors, which include patient-related factors, fracture-related factors, and cast-related factors that may be associated with the redisplacement. In the current study, we tried to fill some of these gaps in clinical research by analysing paediatric patients who suffered from distal radius fractures. However, no studies have reported the incidence of redisplacement after this new type of cast and related risk factors. With the development of new synthetic materials in recent years, a newly instant rigid cast has been used in our hospital, which could potentially reduce patients’ suffering from itchiness, eruption, skin irritation, and bad odour. For traditional cast, skin irritation during casting is still a common complaint. It is well known that application of a well-moulded cast or appropriate interosseous mould is critical in minimizing the risk of subsequent redisplacement. Factors that have been implicated in loss of reduction in children are numerous, and different studies undertaken to define their roles have not been able to give convincing results. The rates of redisplacement in cast have been reported to range from 21 to 39% after acceptable initial reduction. In the clinical practice, closed reduction and cast immobilization is still the most common treatment of distal radius fractures in children.Īlthough closed reduction and cast immobilization has been accepted extensively, we have to confess that there is a very high rate of redisplacement following this treatment. Although several authors have advocated the use of operative methods of fixation such as percutaneous pinning in cases of severe angulation or displacement, some reports have shown similar cost and complication rates between closed reduction and percutaneous pinning. īoth conservative and surgical treatments have been used for distal radius fractures. Fractures in the paediatric population are different from those in adults, due to the ability of bone remodelling while the epiphysis remains open. In the majority of patients, the mechanism of injury is a direct fall and fractures are located in the metaphyso-diaphyseal area. Patients with associated ulna fracture, severe initial translation, and high 3-point index have a higher risk to develop redisplacement.įractures of the distal radius are among the most common injuries presenting to orthopaedic surgeons, which involve up to 27% of all fractures in children. ConclusionsĪbout a quarter of paediatric patients would develop redisplacement after reduction and immobilization with instant rigid cast. In the multivariate analysis, associated ulna fracture (OR, 4.278 95% CI, 1.773–10.320), initial translation ≥ 50% (OR, 9.148 95% CI, 3.587–23.332), and 3-point index ≥ 0.40 (OR, 1.280 95% CI, 1.159–1.401) were three independent factors that correlated with the incidence of redisplacement during follow-up. Twenty-two redisplacements happened within 1 week after treatment, 8 redisplacements happened between 1 and 2 weeks, and only one redisplacement happened after 2 weeks. During follow-up, 31 patients (25.2%) showed redisplacement after closed reduction and cast immobilization. ResultsĪ total of 123 children were included in this study. Risk factors for redisplacement were evaluated in three aspects, which included patient-related, fracture-related, and cast-related factors. Redisplacement was diagnosed on the basis of image findings. Patients were followed up at 1 week, 2 weeks, 3 weeks, and 6 weeks after casting. We retrospectively reviewed paediatric patients who underwent closed reduction and instant rigid cast immobilization for simple distal radius fractures from 2014 to 2018. The aim of this study is to record the incidence of redisplacement after closed reduction and instant rigid cast immobilization and to identify possible risk factors that may be associated with the redisplacement. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |