Die Prognose proximaler Radiusfrakturen im Wachstumsalter

Fractures of the proximal radius in children may lead to deformities of the radial head and functional disturbance of pro- and supination. However, traumatization is not only caused by the injury itself, but may also occur secondary to surgical reduction, manipulation of fracture fragments and excessive physiotherapy. In a prospective long-term follow-study (2–20 years after trauma) of 38 children with displaced proximal radius fractures we found functional disturbances in 11 % of children only. These were not caused by radial head deformities, which were present on 83 % of follow-up radiographs. Functional impairment was mainly seen after open reduction or secondary growth disturbances. On follow-up radiographs all conservatively treated fracture angulations up to 60 ° had corrected themselves spontaneously. In view of the high complication rates after open reduction and the poor functional results, as well as the inconvenience for the pediatric patient and the economic aspects, we recommend a primary conservative treatment concept of proximal radius fractures in children.