Angle Measurement in Critical Forearm Radiography in Pediatric Patients with Forearm Fractures Undergoing Conservative Treatment: Interobserver and Intraobserver Correlation Study

Objective: Forearm fractures account for approximately 40% of child fractures. The elbow is treated conservatively with a 90 degrees flexion cast. The aim of this study was to determine whether patients with forearm fractures who underwent open or closed reduction and fixation after loss of reduction in plaster follow-up is to make interobserver, and intraobserver comparisons of the radiological measurements of fracture angulations and to investigate the effect of these measurements on surgical decision. Method: In the medical records of our clinic between 2013 and 2014, 36 forearm fractures were detected in 35 patients aged 10-15 years who had undergone open reduction, and fixation because of loss of reduction. Patients who had a 1/3 mid-diaphyseal fracture of the radia and ulna and whose radiological controls on days 5, 10, 15 and 31 revealed displacement fractures were retrospectively included in the study. Results: Twenty-two patients who underwent open reduction and fixation were evaluated in terms of concordance between preoperative radiological measurements. ICC (Intraclass correlation coefficient) coefficients were 0.84 (0.69-0.92) for AP radius, 0.95 (0.91-0.97) for AP ulna, and 0.89 (0.80-0.95) for lateral radius, and 0.79 (0.60-0.90) for lateral ulna. According to this, there was a high level of concordance between these four parameters. Conclusion: The decision for surgical treatment of the patients made by different surgeons who are responsible for the treatment is based on the evaluation of the patients as a whole, but not based on measurement of radiological parameters. Although it is considered that the measurement technique may change by experience, there is no statistical difference between the measurements performed by the same person at different times.