University of Oulu

Perhomaa, M., Stöckell, M., Pokka, T., Lieber, J., Niinimäki, J., & Sinikumpu, J.-J. (2023). Clinical Follow-Up without Radiographs Is Sufficient after Most Nonoperatively Treated Distal Radius Fractures in Children. In Children (Vol. 10, Issue 2, p. 339). MDPI AG.

Clinical follow-up without radiographs is sufficient after most nonoperatively treated distal Radius fractures in children

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Author: Perhomaa, Marja1,2; Stöckell, Markus1; Pokka, Tytti3;
Organizations: 1Research Unit of Clinical Medicine, Medical Research Center, Oulu Childhood Fracture and Sports Injury Study, Division of Pediatric Surgery and Orthopedics, Department of Children and Adolescents, (MRC) Oulu, Oulu University Hospital, Oulu University, 90220 Oulu, Finland
2Research Unit of Health Sciences and Technology, Department of Radiology, Oulu University Hospital, Oulu University, 90220 Oulu, Finland
3Research Service Unit, Research Unit of Clinical Medicine, Oulu University Hospital, 90220 Oulu, Finland
4Department of Pediatric Surgery and Pediatric Urology, University Children’s Hospital of Tübingen, 72076 Tübingen, Germany
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
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Language: English
Published: Multidisciplinary Digital Publishing Institute, 2023
Publish Date: 2023-08-09


Distal forearm fractures are common in children and are usually treated nonoperatively. No consensus has been reached on how to perform clinical and radiographic follow-up of these fractures. Our aim was to study whether radiographic and clinical follow-up is justified. We included 100 consecutive patients with non-operatively treated distal forearm fractures who were treated at Oulu University Hospital in 2010–2011. The natural history of the fractures during the nonoperative treatment was analyzed by measuring the potential worsening of the alignment during the follow-up period. The limits of acceptable fracture position were set according to the current literature using “strict” or “wide” criteria for alignment. We determined the rate of worsening fracture position (i.e., patients who reached the threshold of unacceptable alignment). In relation to splinting, we evaluated how many patients benefited from clinical follow-up. Most of the fractures (98%) preserved acceptable alignment during the entire follow-up period when wide criteria were used. The application of stricter criteria for alignment in radiographs showed loss of reduction in 19% of the fractures. Worsening of the alignment was recognized at a mean of 13 days (range 5–29) after the injury. One in three (32%) patients needed some intervention due to splint loosening or failure. Radiographic follow-up of nonoperatively treated distal forearm fractures remains questionable. Instead, clinical follow-up is important, as 32% of patients needed their splints fixed.

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Series: Children
ISSN: 2227-9067
ISSN-E: 2227-9067
ISSN-L: 2227-9067
Volume: 10
Issue: 2
Article number: 339
DOI: 10.3390/children10020339
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
3126 Surgery, anesthesiology, intensive care, radiology
Funding: This research received no external funding.
Dataset Reference: Research data available on request from the authors.
Copyright information: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (