Pearls
Pediatrics:
Majority of both bone fractures are treated with closed reduction.
Can consider bivalve cast if staff have experience with placing it.
If stable reduction with acceptable alignment follow-up can be moved back to 1 week.
Acceptable alignment for midshaft and distal fractures:
- 0-10 yrs : <15° angulation, <45 malrotation, <1 cm shortening.
- >10 yrs: <10° angulation, <30° malrotation, no shortening.
- If close to skeletal maturity (within 2-years): 0° of angulation and 0° of malrotation.
Acceptable alignment for proximal third fractures: Maximum of 10°of angulation and no rotation. Surgery is generally recommended.
Adults:
Treatment is generally operative.
Can attempt closed reduction and splint in sugartong splint.