Malunion of distal radius fractures in children

Figures & data

Figure 1. Case 15. Measurement of the starting malunion angle (panel A) and the final malunion angle (panel B) as described by Hansen et al. (1976).

Figure 2. Case 28. A. Measurement of the starting malunion angle as described by Hansen et al. (1976). B. Measurement of the final malunion angle. New buckle fracture is present.

Table 1. Overview of patient data

Case	Age, years	Sex	Malunion angulation (°)	Angulation direction	Follow-up angulation (°)	RT, months	RS, °/month
1	5.5	F	18	DV	10	10	0.8
2	7	F	20	DV	4	16	1.0
3	6.5	M	20	DV	–1.5	18	1.2
4	9	F	15	DV	9	4	1.7
5	7	M	18	DV	7	6.5	1.7
6	5.5	M	29/21	DV/RU	11/3	10	1.7/1.8
7	3	F	19	DV	10	4	2.2
8	11	F	31	DV	16	6	2.4
9	10.5	M	28	DV	21	3	2.4
10	8	F	25	DV	7	6	3.0
11	8.5	M	26/19	DV/RU	15/14	3	3.6/1.8
12	8	M	30	DV	13	4.5	3.6
13a	8	F	20	DV	5	3.5	4.4
13b	“	F	17	DV	0	3	5.6
14	8	M	29/16	DV/RU	15/9	2.5	5.6/3.0
15	4	F	49/29	DV/RU	19/17	5	6.1/2.3
16	9.5	M	20	RU	17	3	1.0
17	10	F	18	DV	17	5	0.4
18	10	F	16	DV	3	29	0.5
19	10	F	17	DV	7	12	0.9
20	10	F	41	DV	4	22	1.7
21	10.5	F	20	DV	13	3	2.2
22	9.5	M	23/33	DV/RU	14/6	3.5	2.6/7.6
23	9	F	33/18	DV/RU	13/8	5	4.1/1.9
24	11	M	31	DV	4	3.5	7.6
25	14	M	15	RU	6	4	2.2
26	11	F	16	DV	2	27	0.5
27	7.5	F	16	DV	7	16	0.6
28	12.5	M	21	DV	0	23	0.9
29	12.5	M	20	DV	13	8	1.0
30	14	M	15	DV	10	4.5	1.2
31	11	M	28	DV	–2	17	1.8
32	11.5	F	21	DV	1	11	1.8
33	14.5	M	16	DV	8	2.5	3.3

RT: remodeling time; RS: remodeling speed; DV: dorsovolar; RU: radioulnar.

Table 2. Descriptive statistics

Variables	n	Mean (range)
Age, years	33	9 (3–14)
Malunion angulation DV	32	23 (15–49)
Malunion angulation RU	8	21 (15–33)
Angulation at follow-up DV	32	8 (–2 to 21)
Angulation at follow-up RU	8	10 (3–17)
RS DV, °/month	32	2.4 (0.36–7.6)
RS RU, °/month	8	2.7 (0.97–7.6)
RS total, °/month	40	2.5 (0.36–7.6)
RT, months	34	9 (2.5–29)

For abbreviations, see Table 1

Table 3. Correlation with remodeling speed (RS)

Variables	Pearson’s R	p-value
RT	–0.57	0.001
Malunion angulation DV	0.53	0.002
Age	–0.15	0.4
Gender	0.21	0.4

RT: remodeling time; DV: dorsovolar.

Table 4. Models describing the relationship between RS and independent parameters RT, and starting malunion angle (A₀)

Model number	Dependent variable	Significant independent variables	Model	R^2	p-value
1. Linear regression	RS	RT	–0.14RT + 3.71	0.33	0.001
2. Linear regression	RS	A0	0.12A0 + 0.43	0.28	0.002
3. Multiple regression	RS	RT, A0	1.1 – 0.12RT + 0.11A0	0.54	< 0.001; 0.001
4. Exponential	RS	RT	3.43e^-0.67RT	0.44	< 0.001
5. Based on Friberg	RS	RT, A0	A0e^-0.5RT	0.34	< 0.001

RS: remodeling speed; RT: remodeling time; A₀: starting malunions angulation dorsovolar.

Figure 3. Relationship between remodeling speed (RS) and malunion angulation dorsovolar (DV).

Figure 4. Relationship between RS and remodeling time (RT)

Figure 5. Relationship between RS and RT as best-fitting exponential function with RT as exponent.

Hansen B, Greiff J, Bergman F. Fractures of the tibia in children. Acta Orthop Scand 1976; 47: 448–53.

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