Abstract
PurposeDisplaced distal radius fractures in children are common and often reduced if necessary and immobilized in cast. Still, fracture redisplacement frequently occurs. This can be prevented by fixation of fracture fragments with K-wires, but until now, there are no clear guidelines for treatment with primary K-wire fixation. This meta-analysis aimed to identify risk factors for redisplacement after reduction and cast immobilization of displaced distal radius fractures in children, and thereby determine which children will benefit most of primary additional K-wire fixation.MethodsEight databases were searched to identify studies and extract data on the incidence of and risk factors for redisplacement of distal radius fractures after initial reduction and cast immobilization in children.ResultsTwelve studies, including 1256 patients, showed that initial complete displacement (odds ratio [OR] 4.69, 95% confidence interval [CI] 2.98–7.39) and presence of a both-bone fracture (OR 1.95, 95% CI 1.34–2.85) were independent risk factors for redisplacement. Anatomical reduction reduced the redisplacement risk (OR 0.14, 95% CI 0.05–0.40). No significant influence on redisplacement risk could be established for female sex, experience level of the attending surgeon, Cast Index < 0.8, Three-Point Index < 0.8 and patient’s age.ConclusionsFor children with a displaced distal radius fracture, the presence of a both-bone fracture, complete displacement of the distal radius and non-anatomical reduction are risk factors for redisplacement after reduction of their initially displaced distal radius fracture. Children with one or more of these risk factors probably benefit most of reduction combined with primary K-wire fixation.
Highlights
Distal radius fractures account for up to 35% of all paediatric fractures and are mostly caused by a fall on the outstretched hand or direct blow to the arm [1–4]
The results show that the presence of a both-bone fracture, initial complete displacement of the distal radius fragment and non-anatomical reduction are significant risk factors for redisplacement and, present as indications for reduction and additional primary K-wire fixation of paediatric displaced distal radius fractures
Fracture-related factors are often studied as potential risk factors for redisplacement
Summary
Distal radius fractures account for up to 35% of all paediatric fractures and are mostly caused by a fall on the outstretched hand or direct blow to the arm [1–4]. For substantially displaced paediatric distal radius fractures, fracture reduction and cast immobilization is often the treatment of choice. The aim of this meta-analysis was to evaluate the available literature on risk factors for redisplacement of distal radius fractures in children treated with reduction and cast immobilization, and thereby determine which children will benefit the most of primary K-wire fixation additional to cast immobilization. This will aid in establishing guidelines for the treatment of displaced distal radius fractures with primary K-wire fixation
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
