Re‐fractures of the paediatric radius and/or ulna: A systematic review. Issue 4 (22nd September 2021)

• Record Type: Journal Article
• Authors: Bhanushali, Ameya; Axelby, Evelyn; Patel, Prajay; Abu‐Assi, Rabieh; Ong, Belinda; Graff, Christy; Kraus, Manuel
• Is Part Of: ANZ journal of surgery. Volume 92:Issue 4(2022)
• Page Start: 666
• Page End: 673
• Publication Date: 2021-09-22
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1111/ans.17191
• Languages: English
• ISSNs: 1445-1433

Abstract

Abstract: Background: Fractures of the radius and/or ulna are one of the most common injuries in children. Evidence identifying risk factors for refracture, however, has not been summarised in a systematic review. Guidance for counselling patients and parents to minimise the risk of refracture is limited. The aims of this study are to 1) to determine if casting time 6 weeks or less is a risk factor for refracture after paediatric radius and/or ulna fractures, 2) to identify other risk factors for refracture after paediatric radius and/or ulna fractures and 3) to develop more accurate guidelines for counselling parents after a radius and/or ulna fracture in their child. Methods: A thorough search was performed in accordance with the Joanna Briggs Institute (JBI) guidelines for systematic review. JBI Critical Appraisal checklists were used for risk of bias assessment. Results: Diaphyseal both‐bone fractures treated non‐surgically should be casted for longer than 6 weeks. Surgically treated patients can be casted for less than 6 weeks. Diaphyseal and greenstick fractures have a higher risk of refracture. Residual angulation and incomplete healing in greenstick fractures may lead to a higher risk of refracture. Gender does not affect refracture risk. Falls, use of wheeled vehicles, playground activities and trampolining confer high‐risk of refracture. Refracture risk is greatest up to 9 months from initial fracture. Conclusion: Further case‐controlled studies with sub‐group analysis are required to further investigate risk factors for refracture after radius and/or ulna fractures in children. Abstract : This study is a systematic review of the risk factors for refracture after a fracture of the radius and/or ulna in children. Parents may be counselled about several risk factors identified in this study. Further case‐controlled studies are still required to fully investigate the topic.