Distal forearm fractures in children: Diagnosis and assessment
- Paula Schweich, MD
Paula Schweich, MD
- Clinical Professor of Pediatrics
- University of Washington School of Medicine
- Section Editor
- Richard G Bachur, MD
Richard G Bachur, MD
- Section Editor — Pediatric Trauma
- Professor of Pediatrics and Emergency Medicine
- Harvard Medical School
- Deputy Editor
- James F Wiley, II, MD, MPH
James F Wiley, II, MD, MPH
- Senior Deputy Editor — UpToDate
- Deputy Editor — Adult and Pediatric Emergency Medicine
- Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Clinical Professor of Pediatrics and Emergency Medicine/Traumatology
- University of Connecticut School of Medicine
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:
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- PERTINENT ANATOMY
- MECHANISM OF INJURY
- CLINICAL FEATURES
- Nondisplaced Salter I fracture
- Plain radiographs
- - Specific fractures
- Physeal fractures
- - Bone bruise
- Torus (buckle) fractures
- Greenstick fractures
- Complete fractures
- Ulnar styloid fractures
- Galeazzi fractures
- - Associated fractures
- PHYSICAL EXAMINATION
- INFORMATION FOR PATIENTS