Posibles factores de riesgo para reducción abierta en fracturas diafisarias de antebrazo en niños tratadas con clavos elásticos intramedulares

Introduction

Diaphyseal fractures of the forearm are common injuries in the pediatric population and can be treated nonoperative. However, there are specific indications for intramedullary fixation with elastic nails with or without open reduction. The objective was to find predictive risk factors for closed reduction failure in children between 5 and 16 years old.

Material and methods

Descriptive observational retrospective study, case series type. The database of the pediatric orthopedics of a children's hospital was reviewed from January 2017 to December 2021. Data from medical records and pre-operative radiographs were collected to analyze the possible variables related to closed reduction failure.

Results

A sample of 51 patients were analyzed, the average age was 10.68 years (±2.62), with a prevalence of males (82.35%). Twenty-two patients (43.14%) underwent open reduction, 20 (39.22%) closed, and 9 (17.65%) mixed. None of the variables were statistically significant. However, the angulation of the radius in the lateral X-ray showed a value of p = 0.07, which approached statistical significance and could be related to failure in closed reduction.

Conclusion

The findings of this paper can help surgeons to make the decision for open reduction, avoiding risks due to excessive manipulation of soft tissues such as compartment syndrome. A study with a larger sample is needed to increase the statistical power to validate predictive risk factors for failure in closed reduction in the management of diaphyseal fractures of the forearm.

Level of evidence: IV.