Pediatric Distal both Bone Fracture: Failed Closed Reduction

Fractures of the distal radius and forearm are the most common type of fracture encountered by the pediatric population, most frequently the result from a fall on to an outstretched hand (Bochang et al. J Bone Joint Surg Br 87(7):994–6, 2005; Pretell Mazzini and Rodriguez Martin. Int Orthop 34(3):407–12, 2010). Despite appropriate reduction and casting, closed reduction and casting may result in re-displacement in nearly 40% of patients (Alemdaroglu et al. J Bone Joint Surg Am 90(6):1224–30, 2008). Certain risk factors for re-displacement include extent of initial displacement, lack of restoration of anatomic alignment, and cast index; warrant close radiographic follow-up for changes in alignment (McQuinn and Jaarsma. J Pediatr Orthop 32(7):687–92, 2012). If re-displacement is evident, patients may be indicated for operative fixation and casting, as was the case with the patient outlined in this chapter.