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European Journal of Trauma and Emergency Surgery

Published in:

01-04-2021 | Refracture | Original Article

Treatment of nonunion after forearm fractures in children: a conservative approach

Authors: Oliver Loose, Francisco Fernandez, Stewart Morrison, Dorien Schneidmüller, Peter Schmittenbecher, Oliver Eberhardt

Published in: European Journal of Trauma and Emergency Surgery | Issue 2/2021

Abstract

Purpose

Nonunions are a very rare complication after surgical treatment of displaced forearm fractures in children, but can occur in both the radius or ulna. The aim of this study is to evaluate predisposing factors for non-unions and to discuss treatment options.

Methods

We conducted a retrospective analysis of all patients who were treated primarily or secondary at our institution for nonunion after forearm fractures and operative treatment. Therefore, we retrospectively reviewed the medical charts and radiographs of affected patients from 1990 to 2020. We analysed demographic and fracture-related data as well as treatment options.

Results

Twenty-seven cases were identified. Median age was 12 years (7–16 years). The ulna was affected in 20 cases and the radius in 7. The most common location for ulna nonunion was the middle third of the shaft, and for the radius the mid and distal shaft. In 21 cases an open reduction was required. In 9 cases technical problems were identified. In most cases (26/27) a hypertrophic nonunion occurred. 10 of 27 (37%) nonunions healed without any surgical management after 9 (7–15) months. The median age of the conservatively managed group was 10 (6–13) years, younger than in the group with managed with reoperation [median 13 (7–16) years]. Indications for surgical intervention were increasing deformity, pain and limitation of movement.

Conclusion

Open reduction and technical problems seem to be influencing factors. A conservative approach can be adopted in asymptomatic patients, otherwise an operative management, constituting plate osteosynthesis with or without bone grafting, should be performed.

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Title: Treatment of nonunion after forearm fractures in children: a conservative approach
Authors: Oliver Loose
Francisco Fernandez
Stewart Morrison
Dorien Schneidmüller
Peter Schmittenbecher
Oliver Eberhardt
Publication date: 01-04-2021
Publisher: Springer Berlin Heidelberg
Keywords: Refracture
Forearm Fracture
Elastic-Stable Intramedullary Nailing
Published in: European Journal of Trauma and Emergency Surgery / Issue 2/2021
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-020-01583-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Treatment of nonunion after forearm fractures in children: a conservative approach

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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