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Distal ulnar physeal injury.
R J Golz1, D P Grogan, T L Greene
1Department of Orthopaedics, Tulane University School of Medicine, New Orleans, Louisiana.
Journal of Pediatric Orthopedics
|May 1, 1991
Summary
Distal ulnar physis injuries are often difficult to diagnose radiographically. Premature closure and ulnar shortening occurred in 55% of patients, though most remained asymptomatic.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Radiology
Background:
- Injuries to the distal ulnar physis are uncommon but can lead to significant long-term complications.
- Understanding the fracture patterns and consequences is crucial for accurate diagnosis and management.
Observation:
- A review of 18 patients and two amputation specimens revealed injuries involving the distal ulnar physis.
- Type 1 growth mechanism injuries were the most frequent pattern observed.
Findings:
- Premature physeal closure and subsequent ulnar shortening occurred in 55% of patients.
- Other observed consequences included radial bowing, ulnar angulation of the distal radius, and ulnar translocation of the carpus.
- Despite these radiographic findings, most patients were asymptomatic.
Implications:
- The late ossification of the distal ulnar physis can make initial radiographic diagnosis challenging.
- High suspicion for concomitant ulnar physeal injuries is warranted in all distal radius injuries, particularly when ulnar metaphyseal or styloid fractures are not apparent.
- Early recognition and appropriate management are essential to prevent long-term limb length discrepancies and deformities.