![]() ![]() A debate exists as to whether these are more easily treated by completing the fracture, with benefits being greater freedom to proper align and potentially more exuberant callous formation but drawbacks being less fracture stability.įractures of the distal radial metaphysis can commonly also involve the ulna and may present with significant clinical and radiographic deformity. When at different levels, apex volar fractures are usually caused by hypersupination and are reduced in pronation, while apex dorsal fractures are caused by hyperpronation and are reduced in supination. When at the same level, a simple uniplanar reduction maneuver should suffice. When they result from a more pure bending force, the radius and ulna fracture appear at the same level. These fractures typically have a rotational component causing the fractures of the radius and ulna to appear at different levels. Greenstick fractures represent a combination of total cortical disruption and plastic deformation at the fracture site. Not only does simplified treatment perform just as well, patients seem to recover function and return to sports earlier (Plint, 2006 Bae, 2013). This can decrease health care costs and ease family burden. There is excellent evidence confirming the efficacy of simple treatment in the form of a prefabricated splint for 3 weeks, which can be removed at home at the end of treatment and obviate the need for a return visit to the clinic. Advanced imaging is rarely required, however, a CT scan may be helpful to characterize the rare pediatric intraarticular fracture of the distal radius.Ī buckle or torus fracture is inherently stable and recognized by a characteristic unicortical indent in the distal radius. In nonverbal children, sometimes the only sign of injury is decreased spontaneous movement of the extremity.ĪP and lateral radiographs of the wrist will identify subtle and displaced fractures. There is often pain with passive and active range of motion of the forearm, wrist, and hand. The physis is involved in one-third of pediatric distal radius fractures (Mann, 1990).įractures of the distal radius frequently present with pain, swelling, and tenderness localized to the wrist. Their peak incidence is 11-12 years in girls and 13-14 years in boys with the incidence being 1.5 times greater in males than females. Although rare, growth arrest is possible with fractures involving or near the physisįractures of the distal radius are common and represent 31% of fractures occurring in children (Randsborg, 2013).There is increasing evidence supporting use of prefabricated splints over casting for many pediatric distal radius fractures.Closed management is suitable for the vast majority of fractures secondary to the remodeling potential of the distal radial physis. ![]() These fractures are often accompanied by injury to the ulna, the ulnar styloid, distal radioulnar joint (Galeazzi) and increasingly recognized injuries to the TFCC.Fractures of the distal radius are common.Study Guide Distal Radius and Galeazzi Fractures Key Points: ![]()
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