PEDIATRIC FOREARM SHAFT FRACTURES

Forearm fractures are the most common injury type among paediatric fractures. Depending on the physiological healing potential and muscle strength differences, the forearm can be divided into three regions as proximal, shaft and distal. The rate of diaphyseal shaft fractures in paediatric forearm frac-tures is approximately 18%. Paediatric forearm shaft fractures are usually caused by indirect trauma. The most common cause is a fall on the open hand. The diagnosis of forearm fractures is made on radiography. Wrist, forearm and elbow radiographs, anteroposterior and lateral radiographs should be evaluated. The patient’s oedema, presence of open wound, crepitation, presence of compartment syn-drome should be checked and neurovascular examination should be performed in detail. Conservative treatments such as closed reduction and plastering are mostly applied in this fracture type according to the elasticity and remodelling ability of pediatric fractures. If plastering is within the acceptable displacement limits, it is performed under sedation in accordance with plastering techniques and fol-lowed up weekly. In recent years, interest in surgical treatment of shaft and proximal fractures has been increasing. Surgical treatment is considered as a priority in fractures that are outside the accept-able limits after reduction, cannot be reduced, loss of reduction in conservative treatment follow-up, open fractures, pathological fractures, fractures associated with humerus fracture on the same side and accompanied by vascular-nerve injury. Elastic stable intramedullary nails, plate-screw combinations, hybrid methods and external fixators are among the surgical treatments that can be applied. Among these treatment methods, elastic stable intramedullary nails are more preferred. Elastic stable intramed-ullary nails are preferred more than plate-screw osteosynthesis because of shorter surgical time, shorter hospital stay, no damage to the periosteum, minimally invasive, less costly and better clinical results. Although plate-screw osteosynthesis is mostly preferred in adults, it may be preferred in children who are close to completing their development, recurrent fractures and open fractures. Care should be taken in terms of complications that may develop after conservative or surgical treatment. It is important that the rehabilitation to be applied after the treatments is carried out carefully and diligently in order to regain full range of motion and not to cause functional limitation.