Is the operative treatment of displaced diaphyseal forearm fractures in children superior to non-operative treatment? A systematic review of functional outcomes and complications

Abstract

Background: There has been a rising tendency towards surgical intervention for diaphyseal forearm fractures in children in recent years; however, the literature lacks robust evidence for this. The aim of this systematic review was to identify and critically analyse studies examining the functional outcomes and complications of operative versus non-operative treatments for these common injuries. Materials and Methods: A literature search was performed, using MEDLINE, EMBASE, PubMed, Cochrane Central databases and Google Scholar for relevant articles published between January 2005 and December 2015. Results: 253 studies were identified, of which 23 met the rigorous inclusion and exclusion criteria. No significant differences in functional outcomes between the treatment groups were reported by any of the studies. There was a 21.4% complication rate with operative treatment and a 7.2% complication rate with non-operative treatment. Conclusion: This systematic review demonstrates that there is an increasing tendency towards operative management over non-operative treatment during the last decade, especially in older children and adolescents.