6 - Complications of Distal Radius and Ulna Fractures in Children

Abstract

An approximation of a classic Sir John Charnley quote is: “It takes a curved cast to make a straight bone.” Nowhere is this more true that in the setting of fractures of the pediatric distal radius and ulna. However, we would be lucky if crooked was the only thing we had to worry about, as there are a variety of complications that may occur in association with these injuries. By their sheer volume (distal radius and ulna fractures being the most common pediatric fracture), over time any orthopaedic surgeon who regularly treats children will be confronted by one or more of these complications, some subtle and some not so much. The distal radius and ulna are high-growth areas, and this can have both beneficial and detrimental impacts following injury. Very little level I evidence exists to guide the treatment of these injuries; thus, treatment recommendations are based on best available clinical research evidence in conjunction with orthopaedic surgeon clinical expertise/experience and shared decision-making with patients and families. The goal of this chapter is to facilitate the recognition and management of the most common complications associated with distal radius and ulna fractures in children.