دورية أكاديمية
أعرض في EDS

Physeal Fractures of the Distal Ulna: Incidence and Risk Factors for Premature Growth Arrest.

التفاصيل البيبلوغرافية
العنوان: Physeal Fractures of the Distal Ulna: Incidence and Risk Factors for Premature Growth Arrest.
المؤلفون: Lee J; Department of Orthopaedics, Children's Hospital of Philadelphia, Philadelphia, PA., Värk PR; Department of Pediatric Surgery, Tartu University Hospital, Tartu, Estonia., Mendenhall SD; Department of Orthopaedics, Children's Hospital of Philadelphia, Philadelphia, PA., Chang B; Department of Orthopaedics, Children's Hospital of Philadelphia, Philadelphia, PA., Buttrick E; Department of Orthopaedics, Children's Hospital of Philadelphia, Philadelphia, PA., Shah AS; Department of Orthopaedics, Children's Hospital of Philadelphia, Philadelphia, PA.
المصدر: Journal of pediatric orthopedics [J Pediatr Orthop] 2024 Mar 01; Vol. 44 (3), pp. 151-156. Date of Electronic Publication: 2023 Dec 08.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 8109053 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1539-2570 (Electronic) Linking ISSN: 02716798 NLM ISO Abbreviation: J Pediatr Orthop Subsets: MEDLINE
أسماء مطبوعة: Publication: 2000- : Philadelphia : Lippincott Williams & Wilkins
Original Publication: New York Ny : Raven Press
مواضيع طبية MeSH: Radius Fractures*/surgery , Ulna Fractures*/therapy , Fractures, Multiple* , Salter-Harris Fractures*, Child ; Humans ; Adolescent ; Incidence ; Ulna/surgery ; Radius/surgery ; Growth Plate ; Retrospective Studies
مستخلص: Background: The aim of this study is to assess the rate of distal ulnar growth arrest following physeal fracture and to identify specific risk factors for premature physeal closure.
Methods: A retrospective review of patients with a distal ulnar physeal fracture was performed at a single United States children's hospital. Patients without 6-month follow-up were excluded. Patient demographics, injury characteristics, treatment, and outcomes were abstracted. Fractures were classified by the Salter-Harris (SH) system. All follow-up radiographs were reviewed for changes in ulnar variance or signs of premature physeal arrest.
Results: Fifty-six children with distal ulnar physeal fracture at a mean age of 10.7±3.3 years were included with a mean follow-up of 1.9 years. The most common fracture pattern was a SH II (52.7%), versus SH I (29.1%), SH III (9.1%), and SH IV (9.1%). Of displaced fractures (41.1%), the mean translation was 40.2±38.3% the and mean angulation was 24.8±20.9 degrees. Eleven fractures (19.6%) demonstrated radiographic signs of growth disturbance, including 3 patients (5.4%) with growth disturbance but continued longitudinal growth and 8 patients (14.3%) with complete growth arrest. The average ulnar variance was -3.4 mm. Three patients underwent subsequent surgical reconstruction including ulnar lengthening with an external fixator, distal ulna completion epiphysiodesis with distal radius epiphysiodesis, and ulnar corrective osteotomy. Patients with displaced fractures and SH III/IV fractures were more likely to develop a growth disturbance (34.8% vs. 3.2%, P =0.003; 50.0% vs. 11.1%, P =0.012, respectively). Children with less than 2 years of skeletal growth remaining at the time of injury had a higher risk of growth disturbance (46.2% vs. 9.5%, P =0.007).
Conclusions: SH III and IV fractures are more common injury patterns in the distal ulna compared with the distal radius. Growth disturbance or growth arrest occurs in ~20% of distal ulnar physeal fractures. Displaced fractures, intra-articular fractures, fractures requiring open reduction, and older children are at increased risk of distal ulnar growth arrest and should be followed more closely.
Level of Evidence: Level IV--case series.
Competing Interests: The authors declare no relevant conflicts of interest.
(Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
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تواريخ الأحداث: Date Created: 20231208 Date Completed: 20240208 Latest Revision: 20240208
رمز التحديث: 20240208
DOI: 10.1097/BPO.0000000000002585
PMID: 38062866
قاعدة البيانات: MEDLINE
الوصف
تدمد:1539-2570
DOI:10.1097/BPO.0000000000002585