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Complications were analysed separately in connection with the different invasive procedures. Follow-up findings were based on those noted at routine visits learn more to our institution. The median number of both follow-up visits and times of radiographic examination was three (range 1�C9). All postoperative and out-of-hospital visits and radiographs were included. No cases were lost to follow-up. There are several variables that may facilitate the decision-making process concerning operative intervention in cases of paediatric forearm shaft fractures.17 In order to take into account the dissimilar distribution of severe and mild fractures in the invasive and non-invasive treatment groups, we analysed severe and mild fractures separately. The ��severe�� group (N?=?124) included the patients with at least 10-mm displacement in the radius/ulna or both. The ��mild�� group (N?=?44) included the fractures with less or no displacement. The data were analysed by using IBM SPSS Statistics version 20 and StatsDirect statistical software version 2.7.2. Differences in proportions between groups were compared by using the binomial standardised normal deviate (SND) test. Fracture-specific p38 MAPK Kinase pathway risk factors as regards choice of invasive treatment were sought by using univariate logistic regression analysis. Odds ratios (ORs) with their 95% confidence intervals (CIs) were calculated in connection with age (per year of age), gender, severity of primary injury (at least 10-mm displacement in the radius/ulna or both), compound fracture (no/yes) and time of fracture (per year of fracture) in order to identify the factors associated with choice of treatment. A P-value of 0.05 was chosen as a threshold for statistical significance. No approval from Glafenine the Ethics Committee was needed. There were 168 paediatric patients with both-bone middle-third diaphyseal forearm fractures during the study period. Boys predominated (70%, N?=?117) over girls. The mean age of the patients was 8.6 (SD?=?3.9) years. The radiographs showed a mean of 21.4�� of malalignment in the radius and 18.2�� in the ulna primarily. Mean displacement was 4.6?mm in the radius and 2.8?mm in the ulna primarily. According to the radiographs, 26% (N?=?44) of the cases were classified as severe and 74% (N?=?124) as mild fractures ( Table 1). In total, 42% of the patients underwent invasive operation (N?=?71). Internal fixation was performed by ESIN in 66 (93%) cases and by using a plate and screws in five cases. 58% (N?=?97) of all cases were treated by means of closed reduction and external cast fixation. There was no difference in the proportions of internal fixation between the genders: 46% of the boys and 33% of the girls underwent invasive operation (difference 13%, 95% CI ?3.5 to 27.7%, P?=?0.097). Severe fractures were more commonly treated by means of invasive operation (77%) than mild fractures (30%) (difference 47%, 95% CI 60%, P?