Pediatric Forearm Fractures with Unacceptable Angulation: Is Remodeling Effective?

The aim of this study is to examine the remaining deformity after remodeling and its relationship with pronation/supination limitation in patients with unacceptable angulation according to the literature. 45 patients who had forearm fractures treated with closed reduction and plaster cast between 2014 and 2019 were included in the study. The maximum angulation amount was determined on anteroposterior or lateral radiographs by measuring the angulation of the radius and ulna on the radiographs taken during plaster removal (T1) and on the radiographs after remodeling (T2) at the last follow-up. The average follow-up period was 61.6 months (36-90 months). The patients were divided into 2 groups according to the angulation in the radiographs taken on the day the cast was removed (T1): Group 1 (acceptable angulation), and Group 2 (unacceptable angulation). While the average of maximum angulation values at T1 in Group 1 was 8.2 (±2.6) it was 15.4 (±4.1) in Group 2 (p = 0.002). While the mean residual angulation value at T2 was 3.5 (±1.8) in Group 1, it was 6.8 (±3.1) in Group 2 (p = 0.002). It was determined that 7 of 19 patients in Group 1 and 13 of 26 patients in Group 2 had a limitation of more than 10° (p = 0.382). Conservatively treated pediatric forearm fractures have the potential to heal to normal degrees at a high rate after remodeling, even if they have unacceptable angulation degrees, and the pronation/supination limitation in these patients is not directly related to the residual angulation degrees.