Isolated Salter-Harris Type II Fracture of the Distal Ulna

Abstract

Isolated distal ulna epiphyseal plate injuries are very rare and are often associated with early epiphyseal plate arrest. A 13-year-old boy sustained an isolated minimally displaced Salter-Harris type II fracture of the left distal ulna following a fall from a bicycle. The fracture was reduced, and a long arm plaster cast was applied for four weeks. At the six-month follow-up, the patient presented with a painless, full range of movement of the left wrist, but on radiological examination, a mild shortening of the ulna was detected. We plan to regularly evaluate this patient until distal epiphyseal plate closure and surgically intervene if necessary. To our knowledge, this is the third Salter-Harris type II distal ulnar fracture ever reported, and the second treated nonoperatively. It was shown to be associated with a mild growth disturbance. Although Salter-Harris type II injuries are considered benign, surgeons should closely evaluate this rare type II isolated distal ulnar fracture and inform parents regarding possible future complications, which range from clinically insignificant cosmetic deformity to severe instability of the distal radioulnar joint, depending on the degree of shortening.

Isolated Salter-Harris type IV distal ulna fracture: A case report

“…In the reviewed literature and associated case reports, falling onto an outstretched hand is the most commonly reported injury mechanism. More specifically, compression across a pronated forearm in an ulnarly deviated and dorsiflexed wrist has been described [5]. While our patient did not recall the exact wrist position, the mid-radial scaphoid edema noted on the MRI may suggest an axial loading injury on a slightly ulnarly deviated wrist at the time of injury (Figure 2).…”