PubMed^® Literature Review

Pediatric both-bone forearm fractures account for approximately 40% of all pediatric skeletal injuries [5]. Nonoperative management, specifically closed reduction and casting, is generally preferred for fractures that are not significantly displaced or angulated [5]. However, surgical intervention is necessary for significantly displaced or angulated fractures and can involve open reduction and internal fixation (ORIF) or intramedullary (IM) nailing [5].

A retrospective study comparing 17 age- and sex-matched pairs of patients found no significant difference in follow-up times between IM nailing and plating [4]. However, further research reveals contrasting evidence, particularly regarding complications. One study reported a lower complication rate for closed treatment (5%) compared to ORIF (33%) and IM nailing (42%) [6]. These findings raise questions about the risk-benefit trade-off for operative methods.

The current literature lacks an ideal study—a randomized controlled trial comparing closed reduction and casting, intramedullary nailing, and plating in children with various fracture types and long-term follow-up [7]. Such a study would provide valuable insights for evidence-based decision-making and guide clinical practice.

The management of pediatric both-bone forearm fractures is complex, and the available literature presents a mixed picture. Both ORIF and IM nailing hold relevance in the treatment armamentarium, despite complications. Future research, particularly through randomized controlled trials, should address knowledge gaps and provide robust evidence to guide optimal treatment strategies.

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