Physeal Fractures of the Distal Radius and Ulna: Long-Term Prognosis

Abstract

None of the patients reviewed at follow-up, including those with radioulnar length discrepancy of less than 1 cm and those with styloid nonunion, complained of any symptom related to their previous injury, not even those engaged in heavy manual labor. Of the 10 patients with either radial or ulnar shortening of more than 1 cm, only 2 with radial growth arrest and marked radioulnar length discrepancy had severe functional problems. Growth disturbances of more than 1 cm following distal radial physeal injury occurred only in Ogden type 1C, 2B, and 2D lesions, whereas in distal ulnar physeal injuries, growth disturbances occurred regardless of the Ogden classification type.

Skeletally Mature Patients with Bilateral Distal Radius Fractures Have More Associated Injuries

“…This is in accordance with their unilateral counterparts where Salter-Harris type II fractures comprise the majority of distal radial physeal fractures [6]. Of the skeletally mature group, 52% of the fractures were intraarticular and 25% were comminuted, suggesting a much higher amount of energy imparted to the extremity.…”

“…We performed surgery in patients we judged had unstable fractures with metaphyseal comminution or intraarticular derangement. The reported duration of immobilization in distal radius fractures in skeletally immature patients ranges from 3 to 6 weeks, with redisplacement rates reported at 8% [6,24]. These findings suggest, in skeletally immature patients with bilateral distal radius fractures, the mechanism of injury and fracture patterns are similar to those sustained as isolated injuries.…”

Premature Physeal Closure of an Extraphyseal Distal Radius Fracture Secondary to Smooth Kirschner Wire Fixation: A Case Report

“…Disruption is usually secondary to wrist trauma [1][2][3][4][5]. Closure of the radial growth plate occurs most commonly after Salter fractures which involve the physis.…”

“…The majority are physeal Salter-Harris type I or II patterns [2]. Extraphyseal fractures often occur and usually go on to union without complications.…”

Classifications In Brief: Salter-Harris Classification of Pediatric Physeal Fractures

“…Multiple studies examining physeal fractures at the distal tibia also have found that fracture displacement and mechanism of injury are the most significant prognostic indicators [10,25,28]. In a study of distal radius fractures, Cannata et al [5] found that the rate of physeal arrest at the distal radius was less than 30% while the rate of physeal arrest at the distal ulna approached 80%, however, neither was significantly correlated to Salter-Harris classification and fewer than 5% of patients had residual symptoms or functional deficits. The most commonly reported predictors of physeal arrest appear to be initial fracture displacement, mechanism of injury, and accuracy of reduction.…”