Angulated greenstick fractures of the distal forearm in children : Closed reduction by pronation or supination


Published online: Feb 27 2011

Alexander Van Tongel, Pieter Ackerman, Koen Liekens, Bart Berghs

From AZ St Jan Hospital, Brugge, Belgium

Abstract

The purpose of this study was to evaluate a reduction method that is based on the theory of Evans to reduce angulated greenstick fractures of the distal forearm with a rotation manoeuvre, to evaluate an immobilisation technique and to evaluate a brief survey on surgeon practice for treatment of these fractures. A retrospective study was performed on 21 patients. Fractures were reduced with a pronation or supination manoeuvre depending on the angulation of the fracture and were immobilised in pronation or supination. A good reduction was achieved in all patients. Six weeks after manipulation a loss of reduction was seen in 6 out of 21 patients, but with a re-angulation of less than 15°. There was no significant difference between fractures immobilized in pronation or in supination. There was no need for re-manipulation. At the 2008 Osteosynthesis and Trauma Care Foundation (OTC) meeting, a brief informal survey was performed concerning the reduction method and the use of K-wires after reduction. No surgeons indicated they would perform only a rotation manoeuvre.