Retention of forearm plates: risks and benefits in a paediatric population

J Bone Joint Surg Br. 2012 Jan;94(1):134-7. doi: 10.1302/0301-620X.94B1.27155.

Abstract

Most surgeons favour removing forearm plates in children. There is, however, no long-term data regarding the complications of retaining a plate. We present a prospective case series of 82 paediatric patients who underwent plating of their forearm fracture over an eight-year period with a minimum follow-up of two years. The study institution does not routinely remove forearm plates. A total of 116 plates were used: 79 one-third tubular plates and 37 dynamic compression plates (DCP). There were 12 complications: six plates (7.3%) were removed for pain or stiffness and there were six (7.3%) implant-related fractures. Overall, survival of the plates was 85% at 10 years. Cox regression analysis identified radial plates (odds ratio (OR) 4.4, p = 0.03) and DCP fixation (OR 3.2, p = 0.02) to be independent risk factors of an implant-related fracture. In contrast ulnar plates were more likely to cause pain or irritation necessitating removal (OR 5.6, p = 0.04). The complications associated with retaining a plate are different, but do not occur more frequently than the complications following removal of a plate in children.

MeSH terms

  • Adolescent
  • Age Factors
  • Bone Plates / adverse effects*
  • Child
  • Child, Preschool
  • Device Removal
  • Epidemiologic Methods
  • Female
  • Fracture Fixation, Internal / adverse effects
  • Fracture Fixation, Internal / instrumentation*
  • Humans
  • Male
  • Periprosthetic Fractures / etiology
  • Radius Fractures / surgery*
  • Sex Factors
  • Ulna Fractures / surgery*