Forearm longitudinal discrepancy after forearm fractures’ fixation in pediatric: A case series study

Background and Objectives: Forearm fractures in childhood are one of the most common traumatic injuries to the upper extremities. The aim of this study was to investigate the development of growth disturbance after surgical treatment of pediatric forearm fractures and the related factors. Methods: This retrospective descriptive study was conducted on, 38 children with unstable forearm fractures undergoing surgical treatment. Growth disorder, either overgrowth or undergrowth, was investigated using imaging findings. Functional dysfunction, loss of motion, and pain severity were also evaluated in children with developmental disorders. Results: In 13 children (34.2%), forearm longitudinal growth disorder had occurred as overgrowth and no undergrowth was observed in any of the pediatric follow-up periods. The minimum increase in longitudinal growth was 4 mm and the maximum was 10 mm. The mean longitudinal growth was 5.8 ± 1.6 mm. All cases of increased longitudinal overgrowth occurred in the radius. In one case, the longitudinal overgrowth was followed by fixation with Titanium Elastic Nail, and in 12 cases, it was followed by plate fixation. In cases with the increase in longitudinal growth, 12 cases (92.4%) of fractures were in the distal third and 1 case (7.6%) was in the midshaft third. Based on age, there was a significant negative correlation between longitudinal growth and age, so that with decreasing the age of children, the amount of forearm growth increases (P = 0.002, R = −0.8) Conclusions: The most common finding of surgical treatment of pediatric forearm fractures is longitudinal overgrowth. Young age, fractures in the distal third, and the use of plate for fixation appear to be associated with forearm longitudinal overgrowth.