Bowing fractures of the forearm in children: a long-term followup

Abstract

Eleven children with forearm bowing fractures were followed up after 80 months. They were evaluated specifically for pain, function, and cosmesis. Remodeling was assessed by comparing radiographs. The mean age when the trauma occurred was 7 years 5 months. Forces longitudinal to the forearm axis are considered responsible for this injury. In six patients the deforming force was longitudinal, but in two other patients it might have been transversal. In three patients the mechanism of injury was unknown. The initial diagnosis was missed three times. Reduction was cumbersome in five of seven patients. In nine patients a residual curve was accepted. This resulted in a unique opportunity to evaluate the spontaneous remodeling. After 6 years of age, remodeling was less than generally accepted. From this it can be concluded that a transversal force is also capable of causing these injuries, that remodeling is less than generally accepted, and that reduction under general anesthesia should be considered in patients older than 6 years who have a cosmetically unacceptable bowing deformity that is greater than 10 degrees.