Treatment and Prognosis of Displaced Proximal Radius Fractures

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After fractures of the proximal radius in children, severe complications, such as loss of elbow motion and cosmetically disturbing radial head deformities, may occur. Controversial management recommendations regarding the acceptability of initial radial head angulation and side-to-side displacement, treatment, and posttreatment contribute to a confusing discussion. Two to 20 years after the initial accident, 38 children with displaced proximal radius fractures were studied. Radiologically, radial head deformities were present in 83% of cases, whereas functional disorder was present in only four (11%) children. These patients had been treated by open surgical reduction or had a secondary growth disturbance, which resulted in a radioulnar synostosis in one patient. All conservatively treated radial head angulations up to 60° had corrected themselves spontaneously on follow-up radiographs. Thus, the poor functional result, the high complication rate after open surgical treatment, and the inconvenience for the pediatric patient make conservative treatment of proximal radius fractures of up to 60° in children younger than age 10 favorable.

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