Transitional Fracture Patterns of the Pediatric Distal Radius.
Mikaela H Sullivan1, Aliya G Feroe1, Anika Dutta2
1Department of Orthopedic Surgery.
Journal of Pediatric Orthopedics
|September 23, 2025
Summary
Transitional distal radius fractures in adolescents show a consistent pattern, often involving a dorsal ulnar corner fragment. This pattern can guide treatment and predict outcomes for pediatric Salter-Harris III and IV fractures.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Pediatric trauma
Background:
- Distal radius physis fractures are common pediatric upper extremity injuries.
- Transitional distal radius fractures are not well-characterized compared to tibial counterparts.
- This study investigates Salter-Harris III and IV fractures in the pediatric transitional age group.
Purpose of the Study:
- To evaluate Salter-Harris III and IV distal radius fractures in pediatric transitional age patients.
- To determine if a characteristic fracture pattern exists, similar to distal tibia fractures.
- To correlate fracture patterns with treatment and predict outcomes.
Main Methods:
- Retrospective chart review of pediatric patients with distal radius transitional fractures.
- Inclusion of Salter-Harris III and IV fractures with CT imaging.
- Independent review to determine metaphyseal fracture plane and epiphyseal fragments; descriptive statistics.
Main Results:
- Thirty patients (mean age 15) with Salter-Harris III (5) and IV (25) fractures were analyzed.
- Metaphyseal fractures consistently showed a coronal plane (20% sagittal component).
- Dorsal ulnar corner fragments (70%) were most common; angular deformity higher with this fragment (19% vs 0%).
Conclusions:
- Transitional distal radius fractures in adolescents (average age 15) exhibit a consistent pattern.
- A coronal metaphyseal fracture plane and dorsal ulnar corner epiphyseal fragment are characteristic.
- This pattern may inform treatment strategies and outcome predictions for pediatric distal radius fractures.
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