Our results in conservative and surgical treatment of pediatric forearm diaphyseal fractures

This study aimed to retrospectively analyze the radiological and functional outcomes of pediatric patients diagnosed with forearm diaphyseal fractures who were admitted to our clinic between 2016 January and 2024 January. The patients' medical records, outpatient follow-up notes, computerized data, and preoperative and postoperative radiographs were obtained from archives and electronic systems. A total of 83 patients under 16 years of age, diagnosed with forearm diaphyseal fractures, followed for at least six weeks radiologically and clinically after the trauma, and with radiographs taken with appropriate dosage and positioning were included in the study. In this study, the demographic data of the patients were analyzed. Relationships between fracture type and localization, treatment type and localization, fracture type and refracture, and reduction loss and fracture type were evaluated. Various radiological parameters and cast indices were measured. The effects of these indices and parameters on reduction loss, final treatment selection, and the need for open reduction were examined. A significant difference was observed between age groups regarding trauma types. In determining the final treatment, pre-reduction angulation of the radius in the anteroposterior plane, translation, and bayoneting of both the radius and ulna were found to be important. The three-point index was identified as a strong predictor for both final treatment selection and reduction loss. A relationship was found between pre-reduction angulation of the radius, lateral translation of the radius, anteroposterior and lateral translation of the ulna, and bayonetting of the ulna; as well as between post-reduction lateral angulation of the ulna, anteroposterior and lateral translation of the radius and ulna, and the amount of bayonetting of both bones with reduction loss. In conclusion, predicting reduction loss is crucial for maintaining conservative treatment in pediatric forearm diaphyseal fractures, while predicting the final treatment helps avoid unnecessary manipulations. Among cast indices, the three-point index appears to be the most reliable predictor. Key Words: Forearm injury, cast index, closed reduction