Unusual distal radial epiphyseal injury in a child

Arora, Anil; Adedapo, A.; Frcs, D.L Shaw

doi:10.1016/s0020-1383(98)00233-2

Cited by 2 publications

(1 citation statement)

References 2 publications

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“…조기 골단판 폐쇄는 골단판의 직접적인 손상, 장기간의 고정이나 수술적인 침습에 의한 골단판의 허혈, 과다한 반복적인 도수정복에 의한 골단판 의 압박 손상 등에 기인한다. 조기 골단판 폐쇄의 주증상 은 부분적 혹은 완전 성장정지로 인한 각형성과 길이 자람 의 장애로 인한 손목 변형이며 이에 대한 치료 방법은 매 우 다양하다 2,3,5,8,11,12,15,16,19,21,22) 15) . 조기 골단판 폐쇄는 골단판의 직접적인 손상, 장기 고정이나 수술적인 침습에 의한 골판단의 허혈, 과다한 반 복적인 도수정복에 의한 골단판의 압박 손상 등에 기인한 다 5,8,11) .…”

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Epiphyseal Fractures of the Distal Radius in the Children

et al. 2008

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Purpose: To evaluate the long-term results of treatment of epiphyseal fractures of the distal radius in children. Materials and Methods: 23 cases of distal radial epiphyseal fracture, treated by two methods: group 1, closed reduction (CR) plus cast (6 cases); group 2, CR and K-wire fixation (under anesthesia due to marked translation of the distal fragment and swelling) plus cast (17 cases), were selected for this study. All patients were followed up for more than 1 year (average: 3.2 years). Postoperatively, epiphyseal displacement and epiphyseal angulation were measured on anteroposterior and lateral radiographs. At follow-up, the affected and normal sides were compared. Final results were classified by radiologic (radial inclination, volar tilting and radial shortening) and clinical (limitation of ROM, wrist pain, grip strength and wrist deformity) criteria. Results: Group 1 had 5 good, 1 fair result; group 2 had 14 good, 2 fair and 1 poor -there was no statistically significant difference between two groups. All cases where the epiphyseal displacement was less than 30% had good results. A poor case showed a radial shortening, wrist deformity and pain due to premature epiphyseal closure. Premature epiphyseal closure was treated by bar resection and free fat, along with corrective osteotomy when necessary and lengthening of radius with or without epiphysiodesis of the ulna. Conclusion: Remodeling can be expected in epiphyseal fractures of the distal radius. Repeated forceful attempts to achieve accurate reduction should be avoided to prevent secondary physeal injury.

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Epiphyseal Fractures of the Distal Radius in the Children

et al. 2008

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Median Nerve Injuries Associated With Distal Radius Fractures

Dennison

2006

Techniques in Orthopaedics

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Median nerve dysfunction associated with distal radius fractures may present acutely, subacutely, or late, and may also be thought of as being from either primary or secondary causes. Primary nerve injuries are rare and secondary factors are more commonly responsible for median nerve dysfunction following distal radius fractures. Secondary factors may include bleeding, fracture displacement, and swelling, as well as the position of the wrist in the cast, splint, or external fixator. Careful inspection and examination of the patient at the time of injury is critical to identify median nerve dysfunction. In cases of identified dysfunction related to secondary factors, prompt intervention [reduction, carpal tunnel release (CTR)] is likely to yield an excellent outcome while the outcome of primary injury (in the absence of other extrinsic factors) is more related to the degree of the initial insult. Serial examination of sensibility, pain, and thenar muscle function is paramount. Measurement of carpal tunnel pressure may be helpful but does not negate physical examination findings. Controversy remains over whether prophylactic CTR is necessary after volar plating of distal radius fractures. There is incomplete data regarding this issue, but thus far, it would appear that routine prophylactic carpal tunnel is not necessary. Patients with a preinjury carpal tunnel syndrome, symptoms of median nerve dysfunction or those that have higher energy injuries that may be difficult to monitor postoperatively, are perhaps better candidates for concomitant carpal tunnel release.

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Unusual distal radial epiphyseal injury in a child

Cited by 2 publications

References 2 publications

Epiphyseal Fractures of the Distal Radius in the Children

Epiphyseal Fractures of the Distal Radius in the Children

Median Nerve Injuries Associated With Distal Radius Fractures

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