Re-fractures of the paediatric radius and/or ulna: A systematic review
Corresponding Author
Ameya Bhanushali MBBS
Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, South Australia, Australia
Correspondence
Dr. Ameya Bhanushali, Department of Orthopaedics and Trauma, Royal Adelaide Hospital, 42 William St, Clarence Park, Adelaide, SA 5031, Australia.
Email: [email protected]
Contribution: Data curation, Formal analysis, Investigation, Writing - original draft, Writing - review & editing
Search for more papers by this authorEvelyn Axelby MBBS, BDS
Department of Orthopaedics and Trauma, Lyell McEwin Hospital, Adelaide, South Australia, Australia
Contribution: Data curation, Investigation
Search for more papers by this authorPrajay Patel MBBS
Department of Orthopaedics and Trauma, JKC Hospital, Barsana, India
Contribution: Data curation, Investigation, Methodology
Search for more papers by this authorRabieh Abu-Assi MBBS
Centre for Orthopaedic and Trauma Research, The University of Adelaide, Adelaide, South Australia, Australia
Contribution: Data curation, Investigation
Search for more papers by this authorBelinda Ong MBBS
Centre for Orthopaedic and Trauma Research, The University of Adelaide, Adelaide, South Australia, Australia
Contribution: Data curation, Investigation
Search for more papers by this authorChristy Graff MBBS, FRACS
Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, South Australia, Australia
Centre for Orthopaedic and Trauma Research, The University of Adelaide, Adelaide, South Australia, Australia
Department of Orthopaedics and Trauma, Women's and Children's Hospital, Adelaide, South Australia, Australia
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Supervision, Writing - review & editing
Search for more papers by this authorManuel Kraus MD
Department of Orthopaedics and Trauma, University Children's Hospital Basel, Basel, Switzerland
Contribution: Conceptualization, Data curation, Supervision
Search for more papers by this authorCorresponding Author
Ameya Bhanushali MBBS
Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, South Australia, Australia
Correspondence
Dr. Ameya Bhanushali, Department of Orthopaedics and Trauma, Royal Adelaide Hospital, 42 William St, Clarence Park, Adelaide, SA 5031, Australia.
Email: [email protected]
Contribution: Data curation, Formal analysis, Investigation, Writing - original draft, Writing - review & editing
Search for more papers by this authorEvelyn Axelby MBBS, BDS
Department of Orthopaedics and Trauma, Lyell McEwin Hospital, Adelaide, South Australia, Australia
Contribution: Data curation, Investigation
Search for more papers by this authorPrajay Patel MBBS
Department of Orthopaedics and Trauma, JKC Hospital, Barsana, India
Contribution: Data curation, Investigation, Methodology
Search for more papers by this authorRabieh Abu-Assi MBBS
Centre for Orthopaedic and Trauma Research, The University of Adelaide, Adelaide, South Australia, Australia
Contribution: Data curation, Investigation
Search for more papers by this authorBelinda Ong MBBS
Centre for Orthopaedic and Trauma Research, The University of Adelaide, Adelaide, South Australia, Australia
Contribution: Data curation, Investigation
Search for more papers by this authorChristy Graff MBBS, FRACS
Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, South Australia, Australia
Centre for Orthopaedic and Trauma Research, The University of Adelaide, Adelaide, South Australia, Australia
Department of Orthopaedics and Trauma, Women's and Children's Hospital, Adelaide, South Australia, Australia
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Supervision, Writing - review & editing
Search for more papers by this authorManuel Kraus MD
Department of Orthopaedics and Trauma, University Children's Hospital Basel, Basel, Switzerland
Contribution: Conceptualization, Data curation, Supervision
Search for more papers by this authorAbstract
Background
Fractures of the radius and/or ulna are one of the most common injuries in children. Evidence identifying risk factors for refracture, however, has not been summarised in a systematic review. Guidance for counselling patients and parents to minimise the risk of refracture is limited. The aims of this study are to 1) to determine if casting time 6 weeks or less is a risk factor for refracture after paediatric radius and/or ulna fractures, 2) to identify other risk factors for refracture after paediatric radius and/or ulna fractures and 3) to develop more accurate guidelines for counselling parents after a radius and/or ulna fracture in their child.
Methods
A thorough search was performed in accordance with the Joanna Briggs Institute (JBI) guidelines for systematic review. JBI Critical Appraisal checklists were used for risk of bias assessment.
Results
Diaphyseal both-bone fractures treated non-surgically should be casted for longer than 6 weeks. Surgically treated patients can be casted for less than 6 weeks. Diaphyseal and greenstick fractures have a higher risk of refracture. Residual angulation and incomplete healing in greenstick fractures may lead to a higher risk of refracture. Gender does not affect refracture risk. Falls, use of wheeled vehicles, playground activities and trampolining confer high-risk of refracture. Refracture risk is greatest up to 9 months from initial fracture.
Conclusion
Further case-controlled studies with sub-group analysis are required to further investigate risk factors for refracture after radius and/or ulna fractures in children.
Open Research
Data availability statement
The data from which the results of this study were determined may be made availableby request.
Supporting Information
| Filename | Description |
|---|---|
| ans17191-sup-0001-Supinfo.docxWord 2007 document , 32.5 KB | Appendix S1: Supplementary digital content List of supplementary digital content Appendix 1: PRISMA 2020 checklist Appendix 2: Search strategy Appendix 3: JBI critical appraisal checklist for cohort studies Appendix 4: JBI critical appraisal checklist for case series Appendix 5: JBI critical appraisal checklist for case reports |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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