Pediatric Fracture of the Forearm and Wrist

Pediatric fractures of the forearm are the most common injuries in childhood and include fractures of the forearm shaft, fractures of the distal radius and ulna, as well as specific patterns known as Monteggia and Galeazzi fractures. These injuries have a higher incidence in school-age children and adolescents, being typically the result of low-energy falls onto a hand with a rotational component. Diaphyseal forearm fractures have a bimodal distribution; with peak incidence rates at 5–9-year-old and at 10–14-year-old patients. While distal forearm fractures account for 5–10% of children and are more frequent during teenage years. Treatment by closed reduction and casting is always the first choice due to the remodeling capacity of the immature skeleton. Surgical fixation is generally indicated if an attempt at closed reduction and casting is unsuccessful.