ArticleActa orthopaedica2025
The risk of refracture and malunion in children treated for diaphyseal forearm fractures: a retrospective cohort study.
Article in Acta orthopaedica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed.
- Should we remove flexible intramedullary nails after diaphyseal forearm pediatric fracture? A cohort study of 288 patients.Acta orthopaedica · 2026Article
- Letter to the editor: "Forearm fractures treated with elastic stable intramedullary nailing: Is casting still necessary?"Journal of children's orthopaedics · 2026Article
- Sex-Based Anatomical Variations and Complication Risks in Pediatric Both-Bone Forearm Fractures: A Level of Evidence IV Retrospective Analysis.Children (Basel, Switzerland) · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeThe optimal treatment modality for pediatric diaphyseal forearm fractures is debated. While nonoperative treatment and closed reduction reduces the need for surgery and surgical complications, flexible intramedullary nailing (FIN) may reduce refracture and malunion rates. We aimed to compare the relative risk (RR) of refracture and malunion between nonoperative, closed reduction (CR), and surgical treatment in children treated for diaphyseal forearm fractures.
methodsWe performed a retrospective cohort study of children treated for a primary diaphyseal forearm fracture over a 9-year period at 2 university hospitals. Risk of refracture and malunion in the year following the fracture across treatment modalities was assessed by a modified Poisson regression while adjusting for the age of the patient at the time of fracture.
resultsWe included 837 patients for analysis, of whom 4% were treated nonoperatively, 6% were treated with closed reduction, and 90% with FIN. Compared with FIN, the RR of refracture was higher for the nonoperative group (9.8, 95% confidence interval [CI] 5.9-16.3) and CR group (2.5, CI 1.2-5.3). Compared with the FIN group, the nonoperative and CR groups had higher risk of malunion with RR of 15.3 (CI 11.0-21.4) and 8.5 (CI 5.8-12.5) respectively. Of those treated non-surgically, 84% remained without any surgery. In FIN patients, surgical revision due to infection was seen in 1.4% of patients.
conclusionThe risk of refracture and malunion in children treated for diaphyseal forearm fractures was significantly higher for closed reduction and nonoperative treatment compared with FIN treatment.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.