Remodeling of Salter-Harris Type II Epiphyseal Plate Injury of the Distal Radius

Abstract

The authors studied the relation between residual angulation at the time of healing and final orientation of the distal radius as well as the clinical outcome in patients after Salter-Harris type II epiphyseal plate injury of the distal radius. Eighty-five patients were reviewed with a median follow-up of 8.5 years. Anteroposterior and lateral radiographs were taken at follow-up. The mobility of both wrists and forearms was examined, together with grip strength. Pain with activities and sports was evaluated. At follow-up, 73 patients (86%) were anatomically normal on radiographs; the remaining 12 patients had an incomplete remodeling of the volar and/or radial inclination of the distal radius. Premature closure of the growth plate in the distal radius or ulna did not occur in any of these children. Complete remodeling was seen in children aged up to 10 years in all but one patient. Remodeling after Salter-Harris type II epiphyseal plate injury occurs in all age groups, but the potential is greater in children up to 10 years of age. The incomplete remodeling does not seem to have any substantial long-term negative effect on mobility of the wrist and grip strength.

Outcomes of Nonoperative Treatment of Salter-Harris II Distal Radius Fractures

“…Houshian et al 5 than 10 years at the time of injury. Thirty-three of 34 (97%) patients aged 10 years or younger and 47 of 51 (92%) of children older than 10 years completely remodeled radial inclination.…”

“…5,12 Salter-Harris II (SH II) fractures comprise the majority of physeal injuries. 9 Despite the common occurrence of these injuries, we know little about the natural history of SH II DRFs.…”

Treating Displaced Distal Forearm Fractures in Children

“…In contrast, anatomical reduction appears to be crucial in E2 fractures. We cannot confirm the small number of secondary manipulations presented by Houshian [17] and the question remains if our indication for rereduction is too rigorous in these cases.…”

Primary Care Physician Follow-up of Distal Radius Buckle Fractures

“…2,7 Nevertheless, healing of these more complex injuries is excellent because the distal radius has one of the highest capacities for remodeling. 25 An intervention by an orthopedic surgeon is rarely required, [25][26][27] and these fractures can generally be safely treated by using a splint. However, these injuries may require longer immobilization and different anticipatory guidance.…”