Prospective cohort study of 75 displaced distal radial fractures in 74 children under 15 years, investigating which patient and fracture characteristics predict redisplacement after closed reduction and casting, and testing five radiographic indices — including the authors' newly developed three-point index — for their ability to identify at-risk reductions.
When you see a pediatric distal radius fracture that was initially completely displaced or has an oblique fracture line, flag it as high-risk from the start — these are the fractures most likely to lose reduction in the first week.
After closed reduction, calculate the three-point index on the post-reduction films: a value ≥0.8 should prompt reconsideration of cast technique or surgical fixation, since existing indices like the cast index and padding index will not reliably catch a bad reduction.
Prospective cohort study of 75 displaced distal radial fractures in 74 children under 15 years, investigating which patient and fracture characteristics predict redisplacement after closed reduction and casting, and testing five radiographic indices — including the authors' newly developed three-point index — for their ability to identify at-risk reductions.
When you see a pediatric distal radius fracture that was initially completely displaced or has an oblique fracture line, flag it as high-risk from the start — these are the fractures most likely to lose reduction in the first week.
After closed reduction, calculate the three-point index on the post-reduction films: a value ≥0.8 should prompt reconsideration of cast technique or surgical fixation, since existing indices like the cast index and padding index will not reliably catch a bad reduction.