Forearm and Wrist Fractures

Pediatric forearm and wrist fractures account for nearly half of all childhood fractures, with the distal forearm representing a quarter of these injuries. Most cases stem from falls on outstretched hands, particularly in early adolescence. Effective management requires a thorough neurovascular assessment, including testing radial, median, and ulnar nerve function, and careful inspection for open fractures by removing pre-arrival splints. While torus and greenstick fractures are common and often managed with immobilization, specific angulation thresholds necessitate orthopedic consultation. Complete fractures, especially in adolescents, carry higher risks of displacement and refracture, requiring closer monitoring. Ibuprofen remains the preferred initial pain management strategy for non-displaced fractures. Clinical diagnosis relies on AP and lateral radiographs, though ultrasound can confirm suspicions. Understanding local orthopedic practice guidelines regarding reduction angles is essential for optimal patient outcomes in the emergency department.