Pearls

Reduction of plastic deformity requires procedural sedation. Place the apex of the fracture over a padded wedge and apply gradual pressure for 2-3 minutes. Goal <10-20° of angulation.

1. Plastic deformities with <20° angulation in children less than 4 years-old typically remodel without intervention.
2. 10° is the maximum allowable bowing in patients over 10 years old.
3. (There is variable guidance for patients between 4-10 years old and a local orthopedic surgeon can support that decision.)

Correct plastic deformities that prevent reduction of other injuries or prevent rotation of the forearm.

Complications

Applying abrupt pressure on the fracture increases the chance of fracturing the bone during reduction.