Childhood forearm fractures are very common and typically occur after a fall on an outstretched hand. Early assessment should focus on identifying an open fracture, neurovascular compromise, and/or associated injuries. The correct radiographic diagnosis at the time of injury is essential to proper care.
Initial care of nondisplaced fractures consists of pain control, splinting, and measures aimed at reducing swelling. Nondisplaced distal forearm fractures other than complete fractures of the distal radius and ulna can then be referred for scheduled evaluation and further management by an orthopedist with pediatric expertise.
Closed reduction is adequate treatment for many displaced forearm fractures and is often accomplished under sedation in the emergency department. Prompt orthopedic consultation is indicated for an important subset of these fractures to ensure the best outcome. Early orthopedic follow-up for potentially unstable fractures is essential to avoid long-term complications.
The diagnosis of distal forearm fractures in children will be reviewed here. Management, fracture reduction, and casting of distal forearm fractures and the care of pediatric midshaft forearm fractures is discussed separately: