Which factors affect limitation of pronation/supination after forearm fractures in children? A prospective multicentre study

J.W. Colaris, JH Allema, Max Reijman, Merel Vries, Ulas Biter, RM Bloem, CP Ven, Jan Verhaar

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Introduction: Both-bone forearm fractures in children frequently result in a limitation of pronation/supination, which hinders daily activities. The purpose of this prospective multicentre study was to investigate which clinical factors are related to the limitation of pronation/supination in children with a both-bone forearm fracture. Methods: In four Dutch hospitals, consecutive children (<16 years) who sustained a both-bone forearm fracture were included. Children were followed up for 6-9 months and data from questionnaires, physical examination and X-rays were collected. Univariate and multivariate logistic regression analyses were used to assess the relationship between limitation of pronation/supination (>= 208) and several clinical factors. Results: A group of 410 children with both-bone forearm fractures were included, of which 10 children missed the final examination (follow-up rate of 97.6%). We found that a re-fracture (odds ratio (OR) 11.7, 95% confidence interval (CI) 1.2; 118.5), a fracture in the diaphysis (OR 3.3, 95% CI 1.4; 7.9) and less physiotherapy during follow-up (OR 0.90, 95% CI 0.82; 0.98) were independently associated with a limitation of pronation/supination of 208 or more. Conclusions: These findings imply that a re-fracture and a diaphyseal located fracture were associated independently of each other with a limitation of pronation/supination in children with a both-bone forearm fracture. Furthermore, in children with severe limitation extensive physiotherapy is associated with better functional outcome. (C) 2013 Elsevier Ltd. All rights reserved.
Original languageUndefined/Unknown
Pages (from-to)696-700
Number of pages5
JournalInjury-International Journal of the Care of the Injured
Issue number4
Publication statusPublished - 2014

Research programs

  • EMC MGC-02-53-01-A
  • EMC MM-01-51-01

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