Fracture Patterns Changing for Adolescent Patients

A new study presented at the American Society for Surgery of the Hand annual meeting discusses the changing patterns in childhood fractures, showing that most adolescent acute non-displaced fractures are healing with cast mobilization, according to an AAOS Now report.

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The authors did continue to recommend surgical reduction and internal fixation remain the primary treatment for chronic nonunions, according to the report. The study analyzed 312 children treated between 1995 and 2010 with scaphoid fractures. The study found:
•    71 percent of fractures occurred at the scaphoid waist
•    23 percent occurred at the distal pole
•    6 percent occurred at the proximal pole

The patients with scaphoid waist fractures reported significantly higher median body mass index percentiles than patients with distal pole fractures. Men and participants in extreme or heavy contact sports were also associated with increased risk of fractures in both areas.

An additional study of 222 acute fractures showed that the 201 initially treated with casting could have good results. Of those treated with initial casting, 90 of the acute non-displaced fractures achieved union without surgery.

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