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Review Question - QID 7621

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QID 7621 (Type "7621" in App Search)
Radiographs of a 7-year-old child show mid-diaphyseal fractures of the radius and ulna. Closed reduction with sedation in the emergency department is performed. Postreduction radiographs demonstrate 18 degrees angulation, 30% translation, and what appears to be 20 degrees of rotational malalignment. Based on these findings, what is the next most appropriate step in management?

Another attempt at closed reduction in the operating room

33%

246/747

Open reduction with plating of the radius only

1%

10/747

Open reduction with plating of the ulna only

0%

3/747

Open reduction with plating of both the radius and ulna

12%

92/747

Close monitoring with follow-up radiographs in 1 week

52%

385/747

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In children younger than 8 years of age, acceptable reduction parameters for fractures of the forearm are less than 20 degrees of angulation, 100% translation, and less than 45 degrees of malrotation. Weekly monitoring for loss of reduction and unstable fractures requiring further intervention is needed. When acceptable alignment can be maintained, good outcomes can be expected in this age group. In patients older than 10 years, angulation of less than 10 degrees, full translation, and malrotation of 30 degrees can be accepted. When surgical treatment is indicated, plating of one or both bones is acceptable. However, in this patient, the reduction is acceptable so a repeat closed reduction attempt and surgical treatment are not needed.

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