Displaced paediatric distal radius fractures with volar skin tenting following manipulation and reduction: a report of two cases and literature review

Distal radius fractures are amongst the most common forearm fractures in children and can often be managed with closed reduction and casting for the majority of patients. While the thick periosteum sleeve can be used to guide reduction, it can also make the traction used in an adult patient counterproductive to closed reduction attempts. We report two unusual cases of distal radius fractures with displaced volar fragments in children that required urgent surgical intervention following manipulation and reduction due to concern for skin and neurovascular compromise. While one patient developed post-operative superficial skin necrosis managed conservatively, both children recovered well without long-term complications.