# Primary displacement predicts complications and poorer outcomes after pediatric proximal radius fractures: A retrospective study of 140 fractures

## TL;DR

This study shows that initial displacement in pediatric radius fractures increases the risk of complications and poor long-term outcomes.

## Contribution

The study identifies primary displacement as a key predictor of complications and poor outcomes in pediatric proximal radius fractures.

## Key findings

- Fractures with ≥3 mm displacement had a 6.7 times higher risk of complications.
- Unfavorable outcomes were more common after surgical treatment and in patients with complications.
- Higher Judet classification and physeal involvement also increased complication risks.

## Abstract

Pediatric proximal radius fractures frequently lead to complications and unsatisfactory results, yet the medium- to long-term outcomes of these injuries remain insufficiently studied.

We treated 140 proximal radius fractures in 138 children (median age 10, range 1–16 years) between 2014 and 2019. Fracture characteristics, treatment, complications, patient-reported, and functional outcomes were assessed at a median follow-up of 6.8 years (range 5–10 years) through clinical assessment or telephone interview in 110 patients (80%).

Less severe fractures (Judet types I–II) were most common (84/140), while 40% were Judet types III–IV. Most fractures (66%) were treated nonoperatively. Complications occurred in 25% of cases and were mainly associated with displacement ≥3 mm (Odds ratio (OR) 6.7, 95% confidence interval (CI) 2.7–19.1), physeal involvement (OR 5.1, 95% CI 2.0–15.7), and higher Judet classification (OR 4.2, 95% CI 1.9–9.7). Unfavorable functional outcomes occurred in 16% (11/67) and were more frequent after surgical treatment (OR 5.0, 95% CI 1.3–19.6) and in patients with complications (OR 9.2, 95% CI 1.8–47.0).

In pediatric proximal radius fractures, primary displacement ≥3 mm, higher Judet’s class, and physeal involvement increased the risk of complications and unfavorable long-term outcomes.

Prognostic study, Level III