Avascular Necrosis of an Adolescent Distal Radius: A Literature Review

A 12-year-old boy was tackled mid-air, resulting in a fall on the outstretched hand without fracture. The patient was treated conservatively but developed sharp pain and stiffness 6 months later. Imaging revealed distal radius avascular necrosis with physeal involvement. Owing to the injury chronicity and location, we treated the patient conservatively with hand therapy. After 1 year of therapy, the patient returned to normal activities without pain and with a resolution of findings on imaging. Avascular necrosis is more frequent in carpal bones (eg, Kienböck disease of the lunate and Preiser disease of the scaphoid). Growth arrest at the distal radius can lead to ulnocarpal impaction, triangular fibrocartilage complex injury, or distal radioulnar joint injury. In this case report, we discuss our treatment rationale and review the literature on pediatric avascular necrosis for hand surgeons.