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Paediatric forearm and distal radius fractures: risk factors and re-displacement—role of casting indices

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Abstract

Forearm fractures represent one of the most common fractures in children aside from clavicle fractures, and the distal radius is the most common fracture site accounting for 20–30% of these fractures. Maintaining acceptable reduction is not always possible, and re-displacement or re-angulation is the most commonly reported complication. Factors leading to this complication can be broadly divided into three groups: fracture-, surgeon- and patient-related. The quality of casting has been historically measured subjectively. The description of several casting indices by different authors has been a major undertaking, attempting to address objective assessment of this factor. The following have been described: cast index, padding index, gap index, three point index and second metacarpal-radius angle. For distal radius fractures we think that the three point index is the most valuable measurement for predicting re-displacement among surgeon related factors; this index has not been used in forearm fractures in which the rest of the indices seem to be useful in predicting re-displacement. The casting indices should not be interpreted as a separate issue but in conjunction with fracture characteristics and patient factors.

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Authors and Affiliations

  1. Orthopaedic Surgery, 12 de Octubre Hospital, Madrid, Spain

    Juan Pretell Mazzini

  2. Trauma & Orthopaedics, Infanta Leonor Hospital, Madrid, Spain

    Juan Rodriguez Martin

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  1. Juan Pretell Mazzini
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  2. Juan Rodriguez Martin
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Correspondence to Juan Pretell Mazzini.

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Pretell Mazzini, J., Rodriguez Martin, J. Paediatric forearm and distal radius fractures: risk factors and re-displacement—role of casting indices. International Orthopaedics (SICOT) 34, 407–412 (2010). https://doi.org/10.1007/s00264-009-0904-0

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  • DOI: https://doi.org/10.1007/s00264-009-0904-0

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