Chapter 25 - Pediatric Distal Radius Fractures

Abstract

Distal forearm fractures are one of the most common fractures accounting for about 40% of all long bone fractures in children. A peak incidence is seen in girls between 10 and 12years and in boys between 12 and 14years. The key difference between the child's bone and that of an adult is the physis that needs to be taken into account for the treatment of these fractures. Physeal injuries are very common in children, making up 15% of all distal forearm fractures. The distal physis of the radius accounts for 75% of the growth of the radius and 40% of the growth of the entire upper extremity, thereby remodeling potential in the distal forearm is highest in the sagittal plane because of the highest range of motion in this plane (flexion-extension). Multiple attempts at reduction, and late re-manipulation more than 7days post injury are known risk factors for physeal growth arrest. Remodeling potential of pediatric distal radius fractures (DRFs) makes the choice between nonoperative treatment and operative treatment more complex than in the adult population.