Radiological Criteria for Acceptable Alignment in Paediatric Mid-Shaft Forearm Fractures: A Systematic Review
Introduction: Forearm fractures are common in children. The remodelling capacity of growing long bones in children makes these potentially forgiving injuries, recovering with good outcomes despite minimal intervention. Clinicians rely on radiological characteristics that vary with age to guide trea...
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| Format: | Article |
| Language: | English |
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Malaysian Orthopaedic Association
2023-11-01
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| Series: | Malaysian Orthopaedic Journal |
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| Online Access: | https://www.morthoj.org/2023/v17n3/forearm-fractures.pdf |
| _version_ | 1827397782162374656 |
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| author | Scotcher M Chong HH Asif A Kulkarni K |
| author_facet | Scotcher M Chong HH Asif A Kulkarni K |
| author_sort | Scotcher M |
| collection | DOAJ |
| description | Introduction:
Forearm fractures are common in children. The remodelling capacity of growing long bones in children makes these potentially forgiving injuries, recovering with good outcomes despite minimal intervention. Clinicians rely on radiological characteristics that vary with age to guide treatment decisions and minimise adverse sequelae. The purpose of this review was to consolidate the evidence base of radiological indications for intervention in paediatric midshaft forearm fractures.
Materials and methods:
The preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were followed for this review. Citable research output reporting radiological criteria for mid-shaft forearm fractures in paediatric patients (age ≤16 years) was screened and analysed to ascertain acceptable radiological criteria for nonoperative management.
Results: A total of 2,059 papers were initially identified; 14 were selected following screening. Sagittal angulation >15°, coronal angulation >10°, and/or >50% (or >1cm) translation were the most common radiological indications for intervention in children aged 0 to 10 years. For children over 10 years of age, the most common radiological indication for intervention was sagittal angulation >10°, coronal angulation >10°, and/or >50% (or >1cm) translation. Conclusion:
This study revealed a scarcity of high-quality evidence to guide management and significant variation in outcome reporting throughout the published literature. Since Noonan and Price's 1998 recommendations, there has been no significant evolution in the evidence-base guided threshold for intervention in paediatric mid-shaft forearm fractures. There remains a pressing need for a robust multicentre observational study using the patient-reported outcome measurement information system (PROMIS) to address this complex and controversial area of uncertainty in paediatric trauma management. |
| first_indexed | 2024-03-08T19:17:36Z |
| format | Article |
| id | doaj.art-7f25ba9bdb2a459992262006363e1653 |
| institution | Directory Open Access Journal |
| issn | 1985-2533 2232-111X |
| language | English |
| last_indexed | 2024-03-08T19:17:36Z |
| publishDate | 2023-11-01 |
| publisher | Malaysian Orthopaedic Association |
| record_format | Article |
| series | Malaysian Orthopaedic Journal |
| spelling | doaj.art-7f25ba9bdb2a459992262006363e16532023-12-27T05:16:50ZengMalaysian Orthopaedic AssociationMalaysian Orthopaedic Journal1985-25332232-111X2023-11-01173263210.5704/MOJ.2311.005Radiological Criteria for Acceptable Alignment in Paediatric Mid-Shaft Forearm Fractures: A Systematic Review Scotcher M0Chong HH1 Asif A2Kulkarni K3Department of Plastic Surgery, Addenbrooke's Hospital Cambridge University, Cambridge, United Kingdom Department of Orthopaedic and Trauma, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom Division of Surgery and Interventional Science, University College London, London, United Kingdom Division of Surgery and Interventional Science, University College London, London, United Kingdom Introduction: Forearm fractures are common in children. The remodelling capacity of growing long bones in children makes these potentially forgiving injuries, recovering with good outcomes despite minimal intervention. Clinicians rely on radiological characteristics that vary with age to guide treatment decisions and minimise adverse sequelae. The purpose of this review was to consolidate the evidence base of radiological indications for intervention in paediatric midshaft forearm fractures. Materials and methods: The preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were followed for this review. Citable research output reporting radiological criteria for mid-shaft forearm fractures in paediatric patients (age ≤16 years) was screened and analysed to ascertain acceptable radiological criteria for nonoperative management. Results: A total of 2,059 papers were initially identified; 14 were selected following screening. Sagittal angulation >15°, coronal angulation >10°, and/or >50% (or >1cm) translation were the most common radiological indications for intervention in children aged 0 to 10 years. For children over 10 years of age, the most common radiological indication for intervention was sagittal angulation >10°, coronal angulation >10°, and/or >50% (or >1cm) translation. Conclusion: This study revealed a scarcity of high-quality evidence to guide management and significant variation in outcome reporting throughout the published literature. Since Noonan and Price's 1998 recommendations, there has been no significant evolution in the evidence-base guided threshold for intervention in paediatric mid-shaft forearm fractures. There remains a pressing need for a robust multicentre observational study using the patient-reported outcome measurement information system (PROMIS) to address this complex and controversial area of uncertainty in paediatric trauma management.https://www.morthoj.org/2023/v17n3/forearm-fractures.pdfpaediatricforearmfractureradiologicaloutcome |
| spellingShingle | Scotcher M Chong HH Asif A Kulkarni K Radiological Criteria for Acceptable Alignment in Paediatric Mid-Shaft Forearm Fractures: A Systematic Review Malaysian Orthopaedic Journal paediatric forearm fracture radiological outcome |
| title | Radiological Criteria for Acceptable Alignment in Paediatric Mid-Shaft Forearm Fractures: A Systematic Review |
| title_full | Radiological Criteria for Acceptable Alignment in Paediatric Mid-Shaft Forearm Fractures: A Systematic Review |
| title_fullStr | Radiological Criteria for Acceptable Alignment in Paediatric Mid-Shaft Forearm Fractures: A Systematic Review |
| title_full_unstemmed | Radiological Criteria for Acceptable Alignment in Paediatric Mid-Shaft Forearm Fractures: A Systematic Review |
| title_short | Radiological Criteria for Acceptable Alignment in Paediatric Mid-Shaft Forearm Fractures: A Systematic Review |
| title_sort | radiological criteria for acceptable alignment in paediatric mid shaft forearm fractures a systematic review |
| topic | paediatric forearm fracture radiological outcome |
| url | https://www.morthoj.org/2023/v17n3/forearm-fractures.pdf |
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