Treatment of posttraumatic deformities in the radiocarpal joint in children

Experience with treatment of 1885 children with fracture of the forearm bones is reported. Almost 1/3 (28.1%) were patients with epi-osteoepiphysiolysis of the distal end of the radius. In the majority, the method of treatment was conservative: closed manual reposition and immobilization with plaster cast during 3-4 weeks. Closed one-stage reposition is effective only during the first hours of 2-3 days after the trauma. The deformity following an inveterate epi-osteoepiphysiolysis must be corrected surgically before the physiological closure of the growth zones. The pathogenetic problems of posttraumatic deformities in the radiocarpal articulation are discussed and attention is focussed on the "admissible" types of displacement of the epiphysis (meta-epiphysis). The method of bloodless correction of deformities by means of distraction apparatuses is described. The technique was performed in 41 children with good results.