Surgical management of posttraumatic distal radial growth arrest in adolescents

Thirty adolescents underwent surgery for progressive deformity after posttraumatic distal radial growth arrest at the average age of 14.8 years. Patients underwent ulnar epiphysiodesis (n = 11), ulnar-shortening osteotomy (n = 18), radial osteotomy (n = 7), and combined radial and ulnar epiphysiodesis (n = 3) procedures. A modification of the Mayo Wrist Score (maximum 100) was used to assess functional outcome at an average follow-up of 21 months. Average wrist scores in 24 symptomatic patients improved from 82 to 98 after surgical treatment. All six asymptomatic patients maintained scores of 100. Of 18 patients who underwent ulnar shortening, average ulnar variance was corrected from 4.5-mm positive to neutral. Complications included one case of radial osteotomy displacement and two cases of continued ulnar overgrowth. Surgery for posttraumatic distal radial growth arrest can improve pain and loss of motion in symptomatic adolescents and prevent symptoms in asymptomatic patients with progressive deformity.