Comparison of Pediatric Distal Radius Fracture Patterns according to Age

Kyung-Sub Song; Seung-Hwan Lee; Byeong-Mun Park; Su-Keon Lee; Bong-Seok Yang; Ji-Hyeon Kim

doi:10.12790/ahm.2019.24.2.120

Journal List > Arch Hand Microsurg > v.24(2) > 1125365

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Song, Lee, Park, Lee, Yang, and Kim: Comparison of Pediatric Distal Radius Fracture Patterns according to Age

Original Article

Arch Hand Microsurg 2019;24(2):120-125.

Published online: 5 January 2019

DOI: https://doi.org/10.12790/ahm.2019.24.2.120

Comparison of Pediatric Distal Radius Fracture Patterns according to Age

Kyung-Sub Song, Seung-Hwan Lee, Byeong-Mun Park, Su-Keon Lee, Bong-Seok Yang, Ji-Hyeon Kim

Department of Orthopaedic Surgery, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea

Corresponding author: Seung-Hwan Lee Department of Orthopaedic Surgery, Gwangmyeong Sungae Hospital, 36 Digital-ro, Gwangmyeong 14241, Korea TEL: +82-2-2680-7699, FAX: +82-2-2680-7755, E-mail: java5885@gmail.com, ORCID: https://orcid.org/0000-0002-0432-3857

Received 11 December 201830 January 2019 Accepted 11 February 2019

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.

초록

Purpose:

To compare demographic factors and radiologic parameters between metaphyseal fracture and physeal fracture of distal radius in children.

Methods:

Forty-five children who visited our orthopedic clinic for distal radius fracture were included in this study from May 2010 to February 2017. Patients were divided into 2 groups which are metaphyseal fracture group and physeal fracture group. Demographic factors and radiologic parameters were compared between two groups. Mean age of all patients was 10.18±2.66 years old. There were 39 boys and 6 girls in all patients.

Results:

Among all patients, 26 patients were diagnosed with metaphyseal fracture, 19 patients with physeal fracture. Complete fracture was most frequent in metaphyseal group and Salter–Harris type II fracture was most frequent in physeal group. Between simple metaphyseal group and physeal group, mean age, weight and height were significantly larger in physeal group. Ratio of patients over 10 years old was significantly higher in physeal group than metaphyseal group (p=0.036). There was no significant difference in radiologic and clinical results.

Conclusion:

Physeal fracture occurs more frequently more than 10 years old. Postoperative radiologic result was not significantly different between two groups. In children with distal radius fracture over 10 years old, evaluation for the injury of growth plate are recommended.

Keywords: Distal radius fracture, Children, Physeal fracture, Metaphyseal fracture

REFERENCES

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Fig. 1.

Radiographic example of a 5-year-old female patient with metaphyseal fracture. (A) Preoperative radiographs. (B) Postoperative radiograph. (C) Radiograph after union.

Fig. 2.

Radiographic example of a 12-year-old male patient with metaphyseal fracture. (A) Preoperative radiographs. (B) Postoperative radiograph. (C) Radiograph after union.

Table 1.

Distribution of fracture types

Fracture type	No. of patients
Metaphyseal group (n=26)
Buckle fracture	1 (3.8)
Greenstick fracture	2 (7.7)
Complete fracture	23 (88.5)
Physeal group (n=19)
Salter–Harris I	1 (5.3)
Salter–Harris II	17 (89.5)
Salter–Harris IV	1 (5.3)

Values are presented as number (%).

Table 2.

Injury mechanisms of metaphyseal and physeal groups

	Metaphyseal group (n=26)	Physeal group (n=19)	p-value*
Fall from a height	8 (31)	5 (26)	0.249
Fall from standing height	12 (46)	10 (53)	0.165
Injured at sport	6 (23)	4 (21)	0.458

Values are presented as number (%).

^∗ Chi-square test.

Table 3.

Comparison of demographic factors between metaphyseal fracture group and physeal fracture group

	Metaphyseal group (n=26)	Physeal group (n=19)	p-value
Age (yr)	9.31±2.57	11.37±2.34	0.009∗
Age over 10 (yr)	9 (34.6)	13 (68.4)	0.036†
Weight (kg)	37.10±14.74	45.91±13.98	0.049∗
Height (cm)	139.13±18.44	152.97±17.18	0.016∗
Body mass index (kg/m²)	18.36±3.71	19.22±3.50	0.162∗
Right:left	11:15 (42.3:57.7)	10:9 (52.6:47.4)	0.493†
Boys:girls	21:5 (80.8:19.2)	18:1 (94.7:5.3)	0.222†

Values are presented as mean±standard deviation or number (%).

^∗ t-test.

^† Chi-square test.

Table 4.

Comparison of radiologic and clinical result using t-test

	Metaphyseal group (n=26)	Physeal group (n=19) p-value∗
Epiphyseal angle (°)
Anteroposterior	88.54±2.55	89.58±2.76 0.198
Lateral	89.69±3.90	90.26±4.38 0.647
Flexion (°)	72.26±6.23	70.60±6.12 0.129
Extension (°)	83.61±3.58	82.33±7.47 0.502
Pronation (°)	52.26±5.89	54.28±5.46 0.309
Supination (°)	55.30±5.46	54.28±7.24 0.689

Values are presented as mean±standard deviation.

^∗ t-test.

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