Factors affecting early re-displacement of paediatric diaphyseal forearm fractures at Korle Bu Teaching Hospital

  • Daniel Y. Agbley University of Health and Allied Sciences, Department of Surgery, Ho Teaching Hospital, Ho, Ghana
  • Henry A. Holdbrook-Smith Department of Trauma and Orthopaedic, Korle Bu Teaching Hospital, Korle-Bu-Accra, Ghana
  • Michael Segbefia Department of Trauma and Orthopaedic, Korle Bu Teaching Hospital, Korle-Bu-Accra, Ghana
  • Yao Ahonon Public Health Unit, Korle Bu Teaching Hospital, Korle Bu, Accra, Ghana
  • Kissinger Marfo Public Health Unit, Korle Bu Teaching Hospital, Korle Bu, Accra, Ghana
Keywords: cast index; intermedullary nailing; elastic stable intramedullary nail; open reduction; internal fixation

Abstract

Background: Complete fractures of the forearm have the potential to displace and angulate with overriding fracture fragments. Maintaining acceptable reduction is not always possible, and re- displacement or re-angulation is the most commonly reported complication. Factors responsible for the re-displacement after an initial acceptable reduction have not been clearly defined. The study aimed to determine the factors that influence early re-displacement of paediatric diaphyseal forearm fractures in Korle-Bu Teaching Hospital.
Methods: A prospective study in a cohort of 72 children below the age of 12 years with diaphyseal forearm fracture attending the Orthopaedic clinic were followed with close reduction casting from April 2017-December, 2017. Factors analysed included demographics, initial fracture features and the radiographic indices of the cast quality.
Results: 93.1% (67) of the fractures were because of the children falling on an outstretched arm. Majority of the children had a fracture of the distal 1/3 of the radius (n=38, 52.6%). The overall C.I was 0.8 (SD 0.1). The only significant predictor for predicting re-displacement was children falling on an outstretched hand (p-value=0.0).
Conclusion: This study has shown that the degree of initial displacement and the ability to achieve good reduction with a well moulded cast, constitute the major factors for early re-displacement of paediatric forearm fractures
Keywords: cast index, intermedullary nailing, elastic stable intramedullary nail, open reduction, internal fixation
Funding: Personal funding

Published
2020-09-30
Section
Articles

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print ISSN: 0016-9560