Department of Orthopedics, Noordwest Ziekenhuisgroep Alkmaar, The Netherlands.
Department of Orthopedics, Elkerliek Hospital, Helmond;
Acta Orthop. 2021 Aug;92(4):468-471. doi: 10.1080/17453674.2021.1889106. Epub 2021 Feb 22.
Background and purpose - We have previously shown that children with minimally displaced metaphyseal both-bone forearm fractures, who were treated with a below-elbow cast (BEC) instead of an above-elbow cast (AEC), experienced more comfort, less interference in daily activities, and similar functional outcomes at 7 months' follow-up (FU). This study evaluates outcomes at 7 years' follow-up.Patients and methods - A secondary analysis was performed of the 7 years' follow-up data from our RCT. Primary outcome was loss of forearm rotation compared with the contralateral forearm. Secondary outcomes were patient-reported outcome measures (PROMs) consisting of the ABILHAND-kids and the DASH questionnaire, grip strength, radiological assessment, and cosmetic appearance.Results - The mean length of FU was 7.3 years (5.9-8.7). Of the initial 66 children who were included in the RCT, 51 children were evaluated at long-term FU. Loss of forearm rotation and secondary outcomes were similar in the 2 treatment groups.Interpretation - We suggest that children with minimally displaced metaphyseal both-bone forearm fractures should be treated with a below-elbow cast.
背景与目的-我们之前的研究表明，对于经皮微创复位、干骺端双骨折的儿童，与使用肘上石膏固定（AEC）相比，使用肘下石膏固定（BEC）的患者舒适度更高，对日常活动的干扰更小，且在 7 个月随访时具有相似的功能结局。本研究旨在评估 7 年随访时的结果。
患者与方法-对我们的 RCT 7 年随访数据进行二次分析。主要结局是与健侧相比，前臂旋转丢失的情况。次要结局包括患者报告的结果测量（PROM），包括 ABILHAND-kids 和 DASH 问卷、握力、影像学评估和外观美容。
结果-平均随访时间为 7.3 年（5.9-8.7）。在最初纳入 RCT 的 66 名儿童中，有 51 名在长期随访时进行了评估。两组患者的前臂旋转丢失情况和次要结局相似。
结论-我们建议对于经皮微创复位、干骺端双骨折的儿童，应使用肘下石膏固定。
