Refractures of the radius and ulna in children

Seven hundred and sixty-eight children with displaced forearm fractures requiring reduction were studied retrospectively. Of 38 refractures (incidence 4.9%), 34 occurred within nine months at the original fracture site. The median time to refracture was eight weeks after discontinuing cast immobilisation. Diaphyseal fractures were eight times more likely to refracture than metaphyseal fractures. The risk of refracture was inversely proportional to the duration of cast immobilisation. Cast immobilisation for a minimum of six weeks reduces the risk of refracture by a factor of between four and six. Midshaft forearm fractures are at risk of refracture for sixteen weeks from cast removal.