Physeal Closure and Fracture Pattern in Adolescent Transitional Distal Radius Fractures
Gus Strauss1, Jacob Brennan, David Momtaz
1Department of Orthopaedics, UT Health San Antonio, San Antonio, TX.
Purpose:
To show a correlation between grade of physeal closure and fracture pattern in adolescent transitional distal radius fractures.
Methods:
A retrospective chart review was performed of 490 distal radius fractures, ages 14 to 18, at a single institution between 2007 and 2020. A board-certified orthopaedic hand surgeon reviewed all images. Thirty-six distal-radius fractures were considered adolescent transitional fractures. The review included Salter-Harris classification, fracture fragments, and grade of physeal closure.
Results:
Distal radial physeal closure is 50 times more likely to be of a higher grade in the presence of Salter-Harris type IV fractures ( P <0.001). Closure of the physis is also 7.37 and 13.08 times more likely to be of higher grade in the absence of a dorsal metaphyseal fracture and in the presence of an ulnar corner fracture, respectively ( P =0.011 and 0.021).
Conclusion:
Adolescent transitional fractures of the distal radius occur when the growth plate has a partial closure. The closure pattern of the distal radial physis begins centrally, with subsequent ulnar and then radial closure. In this cohort, there is a correlation between grade of physeal closure and fracture pattern in adolescent transitional distal radius fractures.
Level Of Evidence:
Level IV-diagnostic.
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