Yonsei Med J.  2007 Apr;48(2):255-260. 10.3349/ymj.2007.48.2.255.

Refractures of the Upper Extremity in Children

• Park H
• Yang IH
• Joo SY
• Park KB
• Kim HW

• KMID: 1779528
• DOI: http://doi.org/10.3349/ymj.2007.48.2.255

Abstract

Purpose
To investigate the etiologic factors related to refractures of the upper extremity in children. Patients and Methods: Eighteen refractures were divided into three groups according to the location of the initial fractures. They were analyzed in terms of the type of refractures, fracture patterns, and the existence of an underlying deformity. Results: Of nine supracondylar fractures of the humerus, two involved refractures at the supracondylar region, and the other seven involved the lateral condyle. Underlying cubitus varus was present in six cases. Of three lateral condylar fractures of the humerus, one had a refracture at the supracondylar region, and two cases involved the lateral condyle. One had an underlying cubitus varus. All but one case in the humeral fractures group were late refractures, and were treated with surgery. Of six repeat forearm fractures, five were early type and occurred at the original site within nine weeks, four at the diaphysis of both bones of the forearm, and one at the diaphysis of the ulna. All cases in the forearm fractures group, save one, had volar angulation before the refracture, and were treated conservatively. Conclusion: In the humerus, the underlying cubitus varus was the most important predisposing factor for refractures and lateral condyle fractures were common. In the forearm, volar angulation of the diaphysis was related to refractures, and complete and circular consolidation of the primary fracture of the forearm was thought to be important in prevention.

Keyword

Refracture; upper extremity; children

MeSH Terms

Ulna Fractures/epidemiology
Shoulder Fractures/*epidemiology
Retrospective Studies
Recurrence
Radius Fractures/epidemiology
Male
Humeral Fractures/epidemiology
Humans
Follow-Up Studies
Female
Child, Preschool
Child

Figure

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  Fig. 1 (A) Initial fracture radiograph showing a supracondylar fracture. (B) A refracture radiograph showing a lateral condyle fracture with cubitus varus.

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  Fig. 2 (A) Initial fracture radiograph showing a lateral condyle fracture. (B) A refracture radiograph showing a lateral condyle fracture with cubitus varus.

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  Fig. 3 (A) Initial fracture radiograph showing a greenstick fracture. (B) Follow-up radiograph showing mild angulation and incomplete consolidation. (C) A refracture radiograph showing complete fracture involving both bones of the forearm.

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