Abstract
Objective: The bone remodeling belongs to the cornerstones of bone healing in children. Recently its importance and benefit is overlooked and dominate the more "aggressive" and "effective" way of treatment.
The aim of the study is to bring the role of bone remodeling back into account in case of forearm fracture treatment in children. Methods: A clinical cohort of our department from a year 2017.
Children with uncomplicated forearm fractures with clinical significant fragment displacement were evaluated. Entrance condition to the study was presence of the physis in proband skeleton.
The cut-off conditions were compound fracture or refracture, patients with multiple injury, patients with Monteggio, or Galeazzi lesion. These injuries do affect the way of the forearm fractures treatment.
We study the fracture location, patient's age, treatment methods and the results of treatment. Results: During the year 2017 3392 children were treated in our department because of skeletal injury.
Three hundred and forty six of them suffered uncomplicated forearm fracture. Injury of the distal radius was treated without surgery in absolute majority in all age groups.
On the other hand injury of the radial neck or the ulnar olecranon were treated almost in all cases by osteosynthesis. In case of forearm shaft fractures the proportion of osteosynthesis rised according to age group.
Conclusion: The younger the patient is the more conservative way of treatment of the forearm fracture is used, thanks to bone remodeling. For uncomplicated distal radial injury is non-operative way of treatment fully adequate.
Only displaced intraarticular fractures are absolutely indicated for osteosynthesis. The same is valid for displaced radial neck or olecranon fractures.
In unstable forearm shaft fracture there are only relative indication for osteosynthesis, which rise according to the patients age.