Abstract
PURPOSE: The study aimed to evaluate the risk and contributing factors leading to compensation claims and permanent disability following complications of treatment in the management of paediatric forearm fractures. METHODS: Data were gathered from the Finnish Patient Insurance Centre (PIC), which reviews all claims regarding potential treatment complications in Finland. PIC grants monetary compensation based on excess pain or permanent cosmetic and/or functional disability. We evaluated all claims concerning paediatric forearm fracture management in children under 16 years of age between 1990 and 2019. RESULTS: One hundred and forty-four (58 distal forearm, 55 forearm shaft and 31 proximal forearm) of 226 claims were compensated for a total of 156 separate treatment complications. The overall calculated risk for sustaining a compensated treatment complication was 0.1%. Unsatisfactory standard of surgery was the reason for the compensation in 29/55 children with forearm shaft fractures and delayed diagnosis in 20/31 children with proximal forearm fractures, respectively. Compensation was granted for permanent functional disability to 35 children and for permanent cosmetic disability to 62 children. Permanent functional disability was compensated in 6/58 children with distal, 19/55 with shaft and 10/31 with proximal forearm fractures. CONCLUSIONS: The risk of sustaining a compensated complication of treatment after a paediatric forearm fracture is low. Forearm shaft and proximal forearm fractures are associated with a clearly higher risk of iatrogenic injuries with permanent disability than distal forearm fractures. STUDY SIGNIFICANCE: This paper is significant due to the lack of previous publications on this topic and can contribute to minimizing treatment complications in the future.