UMEM Educational Pearls

  • Pediatric forearm fractures are common, and on the rise due to increasing sporting activity and increasing BMI.
  • The most common mechanism is falling on an outstretched hand, which often leads to rotational displacement. 
  • If not properly reduced, it leads to reduced range of motion.
  • The majority do well with closed reduction, if properly reduced.
  • A recent study (Debrovsky, et al. Ann of Emerg Med), found  the accuracy of bedside ultrasonography to determine when pediatric forearm fractures have been adequately realigned was comparable to fluoroscopy. 
  • Consider using US for post-reduction evaluation of pediatric forearm fractures to reduce radiation exposure, cost, and time.

References

Debrovsky AS, Kempinska A, Bank I, Mok E.  Accuracy of Ultrasonography for Determining Successful Realignment of Pediatric Forearm Fractures. Annals of Emergency Medicine. Vol 65;Number 3. March 2015.