Orthopaedic Surgery, 12 de Octubre Hospital, Madrid, Spain.
Int Orthop. 2010 Mar;34(3):407-12. doi: 10.1007/s00264-009-0904-0.
Forearm fractures represent one of the most common fractures in children aside from clavicle fractures, and the distal radius is the most common fracture site accounting for 20-30% of these fractures. Maintaining acceptable reduction is not always possible, and re-displacement or re-angulation is the most commonly reported complication. Factors leading to this complication can be broadly divided into three groups: fracture-, surgeon- and patient-related. The quality of casting has been historically measured subjectively. The description of several casting indices by different authors has been a major undertaking, attempting to address objective assessment of this factor. The following have been described: cast index, padding index, gap index, three point index and second metacarpal-radius angle. For distal radius fractures we think that the three point index is the most valuable measurement for predicting re-displacement among surgeon related factors; this index has not been used in forearm fractures in which the rest of the indices seem to be useful in predicting re-displacement. The casting indices should not be interpreted as a separate issue but in conjunction with fracture characteristics and patient factors.
前臂骨折除锁骨骨折外，是儿童最常见的骨折之一，而桡骨远端是最常见的骨折部位，占这些骨折的 20-30%。并非总能维持可接受的复位，再移位或再成角是最常报告的并发症。导致这种并发症的因素大致可分为三类：骨折相关、外科医生相关和患者相关。铸型质量历来是主观测量的。不同作者对几种铸型指数的描述是一项重大工作，试图对这一因素进行客观评估。以下已被描述：铸型指数、衬垫指数、间隙指数、三点指数和第二掌骨-桡骨角。对于桡骨远端骨折，我们认为三点指数是预测外科医生相关因素再移位的最有价值的测量指标；该指数尚未用于前臂骨折中，其余指数似乎对预测再移位有用。铸型指数不应被视为一个单独的问题，而应与骨折特征和患者因素结合起来考虑。
