In Reply

Abstract

I thank Drs. Alemdaroglu, Iltar, and Aydogan for their letter about the recent Current Concepts review regarding pediatric distal radius and forearm fractures. Indeed, in reading their comments and reviewing the manner in which the “3-point index” is presented in the review article, clarification is in order. As Alemdaroglu et al. have previously defined, the 3-point index is calculated by adding the ratios calculated on both the lateral and frontal radiographic projections. The resulting sum, if over 0.8, has previously been found to be highly predictive of subsequent loss of radiographic alignment after closed reduction and casting of displaced distal radius fracture in children. In the Current Concepts review, the ratios calculated on the lateral and frontal projections were incorrectly presented independently. As redisplacement after closed reduction of distal radius fractures can be a vexing clinical problem, methods to predict those fractures and patients at highest risk are invaluable. Alemdaroglu et al. should be commended for their efforts in providing another tool with which care providers can assess the quality of reduction and casting. It is indeed my hope that the 3-point index will be correctly used by clinicians everywhere to provide the best possible fracture care to their patients. 3-Point Index in Redisplacement of Distal Radial Fractures in Children: How Should It Be Used?Journal of Hand SurgeryVol. 34Issue 5PreviewWe read the Current Concepts article “Pediatric Distal Radius and Forearm Fractures”1 by Dr. Bae with great interest. Though we are pleased to see our original method “the 3-point index”2 in that Current Concepts review in the Journal of Hand Surgery, we are also concerned that the cutoff value was wrongly given, and even the original letter variables we used were changed. Full-Text PDF