Radius fracture in a child | Physiotherapy for a radius fracture

Radius fracture in a child

Children in particular often fall while playing and are often affected by a distal radius fracture. For diagnosis, the wrist and forearm are x-rayed in at least 2 planes. Now the problem in children is that the bones are still very soft.

Especially the periosteum is very flexible, so that when force is applied, sometimes only the bone breaks, but not the sheath. This can be difficult to see on an X-ray. This is called a green wood fracture. If such a fracture is overlooked and does not spontaneously heal properly, it can lead to growth disturbances and malpositions of the hand or wrist if the growth joints in the bones are affected. If the fracture is recognized and treated appropriately, there is a very good healing tendency in children.

Radial head fracture

Together with the humerus and ulna, the radial head forms the elbow joint and is particularly important for rotational movements in the forearm. When falling on the stretched arm, the force can be transmitted through the bones of the forearm to the elbow and fracture of the radial head can occur. Depending on the extent of the injury, a dislocation, i.e. a displacement of the fracture fragment, occurs.

Symptoms are severe pain, swelling of the elbow and restricted movement. The fracture fragments may be palpable. The diagnosis is made by physical examination and X-ray.

The bones of the forearm and the wrist should also be examined, as there are often concomitant injuries to the ulna. In children, an x-ray should be performed in a side-by-side comparison to rule out a greenwood fracture. After an appropriate immobilization with an upper arm cast, physiotherapeutic treatment is performed.

All released movements should be performed as early as possible to prevent stiffening and permanent movement restrictions. The aim is to restore the original joint function. Contents of the therapy are the improvement of mobility and strength.

Since the nerves of the forearm also run through the elbow, an injury of the nerves must be excluded. If there is an accompanying injury to nerve structures, this can result in loss of sensitivity in the forearm or hand. Depending on the extent of the injury, the symptoms improve over time. A mobilization of the nerves can also be part of the physiotherapeutic treatment.

  • Stable fractures can usually be treated without surgery.
  • Dislocations are treated with osteosyntheses.
  • In comminuted fractures it may be necessary to remove the entire radial head (resection).