Predictors for operative treatment in pediatric proximal third both-bone diaphyseal forearm fractures in children include age and translation, but not initial angulation

• Published in: Journal of children's orthopaedics 2023-04, Vol.17 (2), p.156-163
• Main Authors: Williams, Kevin, Whyte, Noelle, Carl, Jacob R, Marks, Jennifer, Segal, David, Little, Kevin J
• Format: Article
• Language: English
• Subjects: Confidence intervals; Fractures; Orthopedics; Pediatrics; Trauma
• ISSN: 1863-2521; 1863-2548
• DOI: 10.1177/18632521231156941

Introduction: Proximal third diaphyseal fractures of the radius and ulna represent an onerous fracture pattern due to difficulty maintaining acceptable alignment with nonoperative management. Our aim was to identify the factors that increase the odds for a surgical treatment of these fractures. Recognizing these factors can raise awareness to patients who are more likely to require additional care and assist clinicians in counseling families, targeting treatment plans, and constructing follow-up protocols. We hypothesized that the age of the patient, the amount of initial fracture displacement, and the angulation of the fracture would predict the need for operative treatment. Methods: We retrospectively reviewed 276 proximal third diaphyseal forearm fractures at a single tertiary care institution. All patients underwent a nonoperative treatment trial, and if failed continued to surgery. Following a univariate analysis, we constructed a binary multivariate logistic regression model that included age, initial translation, and initial angulation to assess the association between the tested variables. Results: A regression model revealed that age (10 years and older, odds ratio: 8.2, 95% confidence interval: 3.9–17.24, p