Pediatric distal radius fractures and triangular fibrocartilage complex injuries

Area of Science:

• Pediatric Orthopedics
• Hand and Wrist Surgery
• Pediatric Traumatology

Background:

• Distal radius fractures in pediatric patients require careful management considering skeletal immaturity and fracture characteristics.
• Physeal fractures can lead to growth disturbances, necessitating specific treatment strategies.
• Triangular fibrocartilage complex (TFCC) tears can cause ulnar-sided wrist pain in adolescents, often presenting subtly.

Purpose of the Study:

• To outline the management principles for distal radius fractures in children and adolescents.
• To identify indications for surgical intervention in pediatric distal radius fractures and TFCC tears.
• To discuss treatment options for post-traumatic growth arrest and TFCC-related wrist pain.

Main Methods:

• Review of current literature and clinical guidelines for pediatric distal radius fracture management.
• Analysis of indications for surgical treatment, including unstable fractures, open fractures, and neurovascular compromise.
• Evaluation of surgical techniques for managing physeal arrest and TFCC tears in pediatric patients.

Main Results:

• Fracture management is tailored to injury pattern, deformity, and remaining skeletal growth.
• Surgical indications include unstable, irreducible, open, or complex fractures with compromised soft tissues.
• Treatment for growth arrest may involve epiphysiodesis or corrective osteotomies; TFCC tears require surgical repair for persistent pain.

Conclusions:

• Conservative management is appropriate for stable pediatric distal radius fractures, with close monitoring for growth disturbances.
• Surgical intervention is crucial for unstable fractures and TFCC tears to prevent long-term functional deficits.
• Addressing physeal arrest and TFCC pathology promptly can restore normal wrist anatomy and function in pediatric patients.