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 (≥20) 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 20 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.

Children, Forearm fractures, Limitation of pronation/supination
dx.doi.org/10.1016/j.injury.2013.09.041, hdl.handle.net/1765/67561
Injury: International Journal of the Care of the Injured
Department of Orthopaedics

Colaris, J.W, Allema, J.H, Reijman, M, de Vries, M.R, Ulas Biter, L, Bloem, R.M, … Verhaar, J.A.N. (2014). Which factors affect limitation of pronation/supination after forearm fractures in children? A prospective multicentre study. Injury: International Journal of the Care of the Injured, 45(4), 696–700. doi:10.1016/j.injury.2013.09.041