Most surgeons favour removing forearm plates in children.
There is, however, no long-term data regarding the complications of retaining a plate.
We present a prospective case series of 82 paediatric patients who underwent plating of their forearm fracture over an eight-year period with a minimum follow-up of two years.
The study institution does not routinely remove forearm plates. A total of 116 plates were used: 79 one-third tubular plates and 37 dynamic compression plates (DCP). There were 12 complications: six plates (7.3%) were removed for pain or stiffness and there were six (7.3%) implant-related fractures. Overall, survival of the plates was 85% at 10 years.
Cox regression analysis identified radial plates (odds ratio (OR) 4.4, p = 0.03) and DCP fixation (OR 3.2, p = 0.02) to be independent risk factors of an implant-related fracture.
In contrast ulnar plates were more likely to cause pain or irritation necessitating removal (OR 5.6, p = 0.04). The complications associated with retaining a plate are different, but do not occur more frequently than the complications following removal of a plate in children.
2012-01-05
Eng.
The Journal of bone and joint surgery. British volume
The Royal Hospital for Sick Children, 9 Sciennes Road, Edinburgh EH9 1LF, UK. nickclement [at] doctors.org.uk
J Bone Joint Surg Br. 2012 Jan;94(1):134-7
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