Forearm fracture (peds)

Background

  • Mechanism: usually fall on outstretched hand (FOOSH)
  • Comprises 45% of all pediatric fractures
  • peak incidence 10-12 years of age in girls and 12-14 in boys

Clinical Features

  • Point tenderness, swelling, obvious deformity
  • Vast majority involve the distal third of the forearm

Differential Diagnosis

Pediatric forearm fracture types

Evaluation

Workup

  • Radiographs:
    • AP and lateral of forearm
    • Also consider AP and lateral of elbow and/or hand

Diagnosis

Management

Specialty Management[1]

Shaft / Both bone fracture Shaft / Both bone fracture Shaft / Both bone fracture Distal radius/ulna
Age Acceptable Bayoneting Shaft Acceptable Angulations Malrotation Dorsal Angulation
< 9 yrs < 1 cm 15° 45° 30 degrees
> 9 yrs. < 1 cm 10° 30° 20 degrees

Disposition

  • Consult ortho if:
    • Rotational deformity
    • >10 degrees of angulation in children >8 yr
    • >15-20 degrees of angulation in younger children
  • Otherwise, discharge with ortho follow up in 1 week

See Also

External Links

References

  1. Orthobullets. Forearm Fractures - Pediatric