Treatment of simple separation of distal radial epiphysis in children

Czech version

Authors: Karel Čermák; Petr Havránek; Tomáš Pešl
Authors‘ workplace: Department of Paediatric and Trauma Surgery, Charles University of Prague, 3rd Medical School, Thomayer University Hospital, Regional Paediatric Trauma Centre ; Klinika dětské chirurgie a traumatologie 3. LF UK a FTNsP, Praha, Centrum dětské traumatologie
Published in: Úraz chir. 18., 2010, č.3

Overview

Introduction:
Fracture of the distal forearm is one of the most common skeletal injuries in children. The therapeutic approach varies from a non-operative to surgical treatment.

Objective:
Retrospective study of therapeutic methods in simple displaced separation of distal radial epiphysis treated in our department was performed.

Material and Methods:
during the period of 5 years (2004–2008) 509 patients were treated at our out-patient department with separation of the distal radial epiphysis. We evaluated methods of treatment according to the direction and grade of displacement, and stability after closed reduction.

Results:
In the cohort of 509 patients we noted 352 non-displaced and 157 displaced separations of distal radial epiphysis. Only 19 patients were indicated to surgical procedure. In the case of dorsal displacement in 124 patients (94 %) the non-operative treatment with closed reduction and plaster cast was used, no patient was operated on primarily and 8 patients (6 %) were operated on for secondary re-displacement. In case of volar displacement 14 children (70 %) were treated with closed reduction and plaster cast, 1 patient (5 %) was operated on primarily and 5 patients (25 %) were operated on for secondary re-displacement.

Conclusions:
The dorsal displacement of separation of the distal radial epiphysis is more frequent than the volar one. However, the volar displacement is less stable and therefore more frequently indicated for surgical procedure.

Key words:
distal radius, children, physis, Salter-Harris schedule.

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Article was published in

Trauma Surgery

2010 Issue 3