Distal radius fraktur hos børn Reponering +/- K-tråd?

J Pediatr Orthop Volume 32, Number 2 Supplement, September 2012

Although short-arm and long-arm casts may be equally effective, there is nonetheless a risk of redisplacement requiring intervention after initial closed reduction in approximately 20% to 30% of patients.

Given the risk of late displacement, some have questioned whether all displaced distal radius fractures should be stabilized acutely with percutaneous pin fixation. 1993

2002 McLauchlan et al randomized 68 children to either closed reduction or cast immobilization versus immediate pin fixation. Loss of reduction was seen in 21% and 0% of patients treated with casting versus pinning, respectively.However, there was 6% rate of pin-related complications, and clinical function 3 months after injury did not significantly differ between groups.

2005 Miller et al similarly randomized 34 patients to either cast immobilization or percutaneous pinning after closed reduction.

All patients were over 10 years of age and had either complete displacement or >30 degrees of initial angulation.

Among the casting group, 39% required remanipulation for loss of reduction. Among the pinning group, there was a 38% pin-related complication rate.

Overall clinical results and cost of treatment was similar between groups.

J Pediatr Orthop Volume 32, Number 7, October/November 2012

2012

http://drstorm.dk/Instruks_for_laeger/underarm/distal_radius_fraktur.htm