Radial Overgrowth after Surgical Treatment for Pediatric Distal Radius Fractures

Min-Wook Kim; Choong-Young Kim; Dae-Hyun Yoon; Dae-Hee Kim; Jung-Ho Lee; Ji-Hoon Park; Young-Soo Choi

doi:10.4055/jkoa.2016.51.5.365

Journal List > J Korean Orthop Assoc > v.51(5) > 1013467

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Kim, Kim, Yoon, Kim, Lee, Park, and Choi: Radial Overgrowth after Surgical Treatment for Pediatric Distal Radius Fractures

Original Article

Journal of the Korean Orthopaedic Association 2016; 51(5): 365-370.

Published online: 26 October 2016

DOI: https://doi.org/10.4055/jkoa.2016.51.5.365

Radial Overgrowth after Surgical Treatment for Pediatric Distal Radius Fractures

Min-Wook Kim, M.D., Choong-Young Kim, M.D., Dae-Hyun Yoon, M.D., Dae-Hee Kim, M.D., Jung-Ho Lee, M.D., Ji-Hoon Park, M.D., Young-Soo Choi, M.D.

Department of Orthopaedic Surgery, Kwangju Christian Hospital, Gwangju, Korea.

Correspondence to: Choong-Young Kim, M.D. Department of Orthopaedic Surgery, Kwangju Christian Hospital, 37 Yangrim-ro, Nam-gu, Gwangju 61661, Korea. TEL: +82-62-650-5064, FAX: +82-62-650-5066, stemcellchoi@hanmail.net

Received 15 August 2015 Revised 8 December 2015 Accepted 4 March 2016

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to examine the influence of radial overgrowth after surgical treatment for pediatric distal radius fractures.

Materials and Methods

Twenty-two pediatric patients under the age of 10 years who underwent surgical treatment for a distal radius fracture without physeal injury were enrolled in this study. They were divided into 2 groups according to the ulnar fracture; distal radius alone fracture in 9 patients group and radioulnar both fracture in 13 patients group. The radial length, ulnar variance, and radial inclination at the last follow-up X-ray were measured using a simple lateral radiograph. The visual analogue scale (VAS) of distal radioulnar joint pain, the Mayo wrist score, and range of motion of the wrist were assessed for the clinical results.

Results

At mean follow-up period of 3.7 years, radial overgrowth was 2.2 mm (p=0.01) compared with the un-injured side. There was negative ulnar variance on the injured side, an average of 0.8 mm (p=0.01). Clinically, mean VAS was 0.2, and the Mayo wrist score was 99.3. No significant difference in radial overgrowth (p=0.32), ulnar variance (p=0.99), VAS (p=0.29), and the Mayo wrist score (p=0.34) was observed between groups.

Conclusion

Radial overgrowth and negative ulnar variance was observed after surgical treatment of pediatric distal radius fracture without physeal injury. However, the radial overgrowth does not affect clinical outcomes.

Keywords: pediatrics, radius fracture, growth

Figures and Tables

Figure 1

(A) Radial length was measured parallel to the long axis of the radius from radial head articular surface to distal radius articular surface in a simple forearm anteroposterior (AP) X-ray. In this patient, radial length discrepancy was 7.2 mm. (B) Ulnar variance was measured as the distance between a line perpendicular from the carpal joint surface of the distal end of the radius toward ulnar and the carpal surface of the ulnar in a simple forearm AP X-ray. Radial inclination was measured as the angle between one line connecting the radial styloid tip and ulnar aspect of the distal radius and a second line perpendicular to the longitudinal axis of the radius in a simple forearm AP X-ray. Radial inclination discrepancy was not seen in this patient.

Figure 2

In radiologic results, there was no significant difference between distal radius fracture group and radioulnar fracture group. RLD, radial length discrepancy (p=0.32); UVD, ulnar variance discrepancy (p=0.99); RID, radial inclinatioin discrepancy (p=0.57).

Table 1

Demographic Data

Values are presented as number only or median (range).

Table 2

Comparison of Difference between Injured Side and Uninjured Side

Values are presented as mean.

Table 3

Comparison of Difference between Distal Radius Fracture Group and Radioulnar Fracture Group

Values are presented as median (range).

Table 4

Frequency of Gender, Level of the Forearm Fracture, Presence of the Ulnar Fracture by Radial Overgrowth More than 2 mm

Values are presented as number (%).

Notes

^{CONFLICTS OF INTEREST} The authors have nothing to disclose.

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