Year: 2026 | Month: October | Volume: 13 | Issue: 10 | Pages: 238-246
DOI: https://doi.org/10.52403/ijrr.20261022
Management of Pediatric Diaphyseal Forearm Fractures: A Focused Systematic Review of Conservative and Operative Strategies
Panji Sananta1, Respati S. Dradjat1, Daylan Oscar Hermawan1, Aulia Pandu Aji1, Bima Mahardhika Aji1, Alexander Fernando1
1Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Brawijaya – Dr. Saiful Anwar General Hospital, Malang, Indonesia
Corresponding Author: Panji Sananta
ABSTRACT
Introduction: Evidence specific to forearm fractures in children aged 2–5 years is limited, particularly regarding operative indications and the youngest age at which open reduction and internal fixation (ORIF) has been documented. This review synthesised age-specific evidence on shaft-involving forearm fractures in this population.
Methods: A focused systematic review was conducted in accordance with PRISMA 2020. Journal reports were eligible if they included children aged 2–5 years or a separately identifiable subgroup within this age range. ORIF was defined as explicit documentation of open fracture reduction and internal fixation in the same identifiable patient. Data were synthesised narratively because of heterogeneity in study design and outcomes.
Results: Three clinical reports met the eligibility criteria: one retrospective cohort and two case reports. In the cohort, 29 of 33 children aged 2–5 years underwent closed reduction and four underwent open reduction, but individual ages and fixation devices were not reported. A 4-year-old case involved median nerve exploration and reconstruction rather than fracture ORIF. The youngest explicitly documented fracture ORIF was in a 5-year-old, in whom failed closed reduction was followed by plate fixation of the radius, with complete union and full motion at 12 weeks. No exact-age comparative evidence established superiority of casting or any fixation technique.
Conclusion: Evidence in children aged 2–5 years remains limited. Five years was the youngest verifiable ORIF age, not a minimum operative threshold. Management should be individualised according to fracture reducibility, stability, morphology, neurovascular status, and associated injuries.
Keywords: closed fracture reduction, forearm fracture, internal fixation, open fracture reduction, preschool children.
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