The Management of Pediatric Open Forearm Fractures.

J Hand Surg Am · Jun 2020 · Review

Elia G, Blood T, Got C

Department of Orthopaedic Surgery, Providence, RI; Warren Alpert Medical School of Brown University

Hand & Upper Extremity Orthopaedic Trauma Pediatric Orthopaedics

SUMMARY — THE REDUCTIONThis review addresses management strategies for pediatric open forearm fractures, noting that low-grade (type 1) injuries may be safely treated with early antibiotics and ED-based irrigation and stabilization despite lacking standardized, high-level evidence.
Abstract, as published

Open pediatric forearm fractures are common injuries that present to emergency departments across the United States. A total of 32% to 80% of all open pediatric fractures involve the forearm. Standard treatment for these injuries includes prompt intravenous antibiotic administration, tetanus prophylaxis, and usually bedside irrigation as a temporizing measure. Gustilo and Anderson type 2 and 3 open pediatric forearm fractures are generally managed with formal irrigation and debridement and fracture stabilization in the operating room. Management of Gustilo and Anderson type 1 open pediatric forearm fractures is not standardized, and level I evidence is currently lacking. Based on the existing data available, early antibiotic administration, bedside irrigation, and fracture stabilization in the emergency department may be a safe and effective initial treatment for these injuries, conferring a low risk for subsequent infection.

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