Distal radius fractures in children: substantial difference in stability between buckle and greenstick fractures

Background and purpose Numerous follow-up visits for wrist fractures in children are performed without therapeutic consequences. We investigated the degree to which the follow-up visits reveal complications and lead to change in management. The stability of greenstick and buckle fractures of the distal radius was assessed by comparing the lateral angulation radiographically

Classification of distal radius fractures in children: good inter- and intraobserver reliability, which improves with clinical experience

Abstract Background We wanted to test the reliability of a commonly used classification of distal radius fractures in children. Methods 105 consecutive fractures of the distal radius in children were rated on two occasions three months apart by 3 groups of doctors; 4 junior registrars, 4 senior registrars and 4 orthopedic consultants. The fractures were classified as buckle, greenstick, complete or physeal. Kappa statistics were used to analyze inter- and intraobserver reliability. Results The kappa value for interobserver agreement at the first reading was 0.59 for the junior registrars, 0.63 for the senior registrars and 0.66 for the consultants. The mean kappa value for intraobserver reliability was 0.79 for the senior registrars, 0.74 for the consultants and 0.66 for the junior registrars. Conclusions We conclude that the classification tested in this study is reliable and reproducible when applied by raters experienced in fracture management. The reliability varies according to the experience of the raters. Experienced raters can verify the classification, and avoid unnecessary follow-up appointments.</p

Treatment of Instability of the Proximal Tibiofibular Joint by Dynamic Internal Fixation With a Suture Button

Injury to the proximal tibiofibular joint can lead to lateral knee pain and instability owing to chronic rupture of the posterior tibiofibular ligament. The condition is often missed, and the true incidence is unknown. A variety of surgical treatments have been proposed over the last decades. Methods such as arthrodesis and fibular head resection have largely been replaced with various reconstruction techniques using autografts. The purpose of this report is to describe our method for treatment of proximal tibiofibular joint instability by dynamic internal fixation with a suture button