Angulated greenstick fractures of the distal forearm in children: closed reduction by pronation or supination

Alexander Van Tongel, Pieter Ackerman, Koen Liekens, Bart Berghs
Acta Orthopaedica Belgica 2011, 77 (1): 21-6
The purpose of this study was to evaluate a reduction method that is based on the theory of Evans to reduce angulated greenstick fractures of the distal forearm with a rotation manoeuvre, to evaluate an immobilisation technique and to evaluate a brief survey on surgeon practice for treatment of these fractures. A retrospective study was performed on 21 patients. Fractures were reduced with a pronation or supination manoeuvre depending on the angulation of the fracture and were immobilised in pronation or supination. A good reduction was achieved in all patients. Six weeks after manipulation a loss of reduction was seen in 6 out of 21 patients, but with a reangulation of less than 15 degrees. There was no significant difference between fractures immobilized in pronation or in supination. There was no need for remanipulation. At the 2008 Osteosynthesis and Trauma Care Foundation (OTC) meeting, a brief informal survey was performed concerning the reduction method and the use of K-wires after reduction. No surgeons indicated they would perform only a rotation manoeuvre.

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