Today's News

Friday, March 2, 2001

Are routine follow-up radiographs indicated in the management of pediatric distal forearm torus fractures?

The vast majority of distal radius torus fractures do not manifest significant angular displacement prior to union, investigators said Thursday in scientific paper 134. They conclude in their study "there does not appear to be a significant role for routine follow-up radiographs in the management of distal radius torus fractures.

For fractures treated with cast immobilization for at least three weeks we recommend taking an initial diagnostic radiograph only. Forgoing additional radiographic studies avoids the unnecessary exposure of children to radiation and conserves medical resources."

To conduct their study, the radiographs and charts of 98 distal radius torus fractures were retrospectively reviewed at a pediatric tertiary care hospital for the period from 1996-1999. Radiographic measurements quantified any change in angular deformity at the fracture site over time. Radiographs were also examined for evidence of growth arrest. Chart review was utilized to determine if radiographic findings led to changes in the treatment course, to determine treatment type, and to confirm the diagnosis of torus fracture.

Fractures were treated with cast immobilization for an average of 3.4 weeks. An average of 2.9 follow-up radiographs were taken per case. More than 99 percent of distal radius torus fractures manifest a change in angular deformity of less than 8.5 degrees. No cases of physeal growth arrest were identified.

Radiographic findings did not lead to any reductions or operative intervention in the study population.

John H. Lyon, MD; John J. Grayhack, MD; Jafer Ali, BS; and John F. Sarwark, MD, all of Chicago, Ill. are the investigators.

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2001 Academy News March 2 Index C

Last modified 15/February/2001 by IS