Is an Orthopaedic Surgery Resident’s Previous Case Experience Associated with Success of Initial Treatment of Pediatric Forearm Fractures?


Redisplacement and subsequent intervention are common for pediatric forearm fractures. We investigated associations between the success of closed reduction and the treating provider’s experience. We identified patients aged 4–16 years with forearm fractures treated by closed reduction and cast immobilization. Clinical data and radiographs of 130 patients treated by 30 residents were reviewed to determine the treating resident’s pediatric forearm fracture reduction experience and the incidence of initial treatment failure (ITF). ITF was defined as subsequent intervention before union or malunion. ITF occurred in 32 of 130 patients (25%), comprising 12 of 23 patients (52%) treated by residents with no previous experience and 20 of 107 patients (19%) treated by residents who had logged ≥ 1 previous reduction (odds ratio, 4.7). ITF was more likely to occur in pediatric forearm fractures treated by residents with no previous forearm reduction experience compared with those performed by residents who had such experience. Level of Evidence: Level III, therapeutic. (Journal of Surgical Orthopaedic Advances 32(1):032–035, 2023)

Key words: forearm fracture, fracture reduction, malunion, orthopaedic surgery resident, treatment failure

Brett A. Shannon, MD; Brian T. Sullivan, MD; Dawn M. LaPorte, MD; and Paul D. Sponseller, MD, MBA