Department of Orthopedics, Tri-Service General Hospital, Taipei, Taiwan, Republic of China.
J Orthop Trauma. 2012 Feb;26(2):110-6. doi: 10.1097/BOT.0b013e318216b403.
Manipulation and plaster fixation is the primary management for diaphyseal fractures of the radius and/or ulna in children. This study was designed to evaluate risk factors of fracture redisplacement after closed reduction and cast immobilization.
Retrospective study.
Tertiary hospital.
Fifty-seven children with fractures of the radius were included.
The medical records of patients with/without ulna treated with closed reduction and casting were reviewed.
Data analyzed were age, sex, dominant hand, fracture pattern, reduction quality, experience of the surgeon, and type of anesthesia. Logistic regression was used for multivariate analysis.
There were 41 (71.9%) males and 16 (28.1%) females with a mean age of 9.74 ± 3.07 years. There were 53 radius fractures and 54 ulna fractures, and 22 subjects experienced redisplacement. The redisplacement rate of radius fractures was 34% and of ulnar fractures was 27.8%. Multivariate analysis showed that the factors associated with redisplacement of radius fractures were fair reduction quality [odds ratio (OR), 8.45] and complete fracture (OR 9.62) and those for redisplacement of ulna fractures were fair reduction quality (OR 8.10) and complete fracture (OR 8.43).
Poorer reduction and complete fracture are more likely to result in redisplacement, and surgical management may be considered in these cases.
手法复位和石膏固定是儿童桡骨和/或尺骨干骨折的主要治疗方法。本研究旨在评估闭合复位和石膏固定后骨折再移位的危险因素。
回顾性研究。
三级医院。
57 例桡骨骨折患儿。
回顾接受闭合复位和石膏固定治疗的伴/不伴尺骨骨折患者的病历。
分析的数据包括年龄、性别、优势手、骨折类型、复位质量、外科医生经验和麻醉类型。采用多变量逻辑回归进行分析。
男 41 例（71.9%），女 16 例（28.1%），平均年龄 9.74 ± 3.07 岁。53 例为桡骨骨折，54 例为尺骨骨折，22 例发生再移位。桡骨骨折再移位率为 34%，尺骨骨折再移位率为 27.8%。多变量分析显示，与桡骨骨折再移位相关的因素是复位质量一般[比值比（OR），8.45]和完全骨折（OR 9.62），与尺骨骨折再移位相关的因素是复位质量一般（OR 8.10）和完全骨折（OR 8.43）。
较差的复位和完全骨折更容易导致再移位，在这些情况下可能需要手术治疗。
