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BACKGROUND
Forearm is the distal unit of the articulated strut of the upper limb. It extends from the elbow to the wrist and contains two bones, the radius and ulna. A fracture is a complete or incomplete break in a bone resulting from the application of excessive force or due to pathologies.
Forearm fracture in children is a common type of injury in children encountered in hospital every day. The most common mechanism of injury reported is fall related injury especially from playing grounds. . In children, forearm both-bone shaft fractures cover about 6% of all fractures. (Sinikumpu 2013). It has been recognized as among the cause of morbidity and disability in childhood, if it is not handled carefully.
Most of times these fractures have been managed by closed reduction and immobilization by closed cast, but nowadays some of these fractures have been managed by invasive methods like rush roads, kirschner wires plating and percutaneous pins. Most succeeded method being closed reduction.
OBJECTIVE
The main objective of this study is to determine the prevalence, mechanism of injury and management outcome of radius / ulna fracture among children attended in KCMC Orthopedic department from 2013-2015.
METHODS; This study was a hospital based retrospective cross sectional study aiming at establishing prevalence, mechanism of injury and management outcome of radius / ulna fractures among children attended at KCMC Orthopedic department from 2013-2014. The study was conducted to a population of patients who were admitted and/or treated at clinic with radiographic diagnosis of radius and/or ulna fracture. Purposive sampling for children with radiographic diagnosis of radius and ulna fracture was done. Data was collected from patient files. Data processing and analysis was done by using SPSS version 20.0 and study approval was by Head of KCMC Orthopedic Department.
RESULTS: All 103 children have the radiological diagnosis of radius and ulna fracture, boys were 3.5 times more affected than girls, the age of the patients ranged from 2-17 with median
age of 10years meaning that, primary school age children (8-13 years) more affected 56.3% than preschool (1-7years) 22.3% and secondary school (14-17 years) least affected. The most common mechanism of injury was fall related 82.6%. The prevalence was 7.7%. The invasive method have good outcome of about 84%, while none invasive method (cast, back slab and POP) only 74% had good outcomes. Therefore radius and ulna fractures can be managed by Invasive methods in older children and results in acceptable radiological and functional outcome.
CONCLUSION: The non-invasive method of managing radius and ulna fracture seen to result into more complication than invasive methods, this might be due to improper closed reduction and immobilization . So the department should be careful in handling these cases. The play grounds for children especially in primary school should be improved by collaboration between parents and local government also teachers should supervise pupils when they play.
Key words: Prevalence, fracture, radius and ulna, forearm and management outcome. |
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