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Article Details

Clinical Image
Volume 3, Issue 2 (May Issue)

Distal Radius Physeal Closure Following a Salter-Harris II Fracture

D Steinkey1*, RJ Steinkey2 and R Arora1

1Redcliffe Hospital, Metro North, QLD, Australia
2University of Queensland, QLD, Australia

*Corresponding author: Dylan Steinkey, Redcliffe Hospital, Metro North, QLD, Australia. E-mail: Dylan.Steinkey@gmail.com

Received: February 04, 2024; Accepted: February 25, 2024; Published: March 15, 2024

Citation: D Steinkey, RJ Steinkey, R Arora. Distal Radius Physeal Closure Following a Salter-Harris II Fracture. Case Rep Orthop Surg J. 2024; 3(2): 126.

Article Image
Abstract

Figure 1: AP and lateral x-rays of a 12-year-old female’s right hand demonstrating a Salter-Harris II fracture day 1 post injury from falling on an out-stretched hand. Following this incident, she underwent immobilization for four-weeks and five-days in a routine short arm fibreglass cast. Pre-immobilization x-rays could not be retrieved due to file corruption.

Figure 2: AP and lateral x-rays approximately 5 weeks post injury. At this stage the patient experienced no pain, and imaging results were deemed satisfactory. Consequently, she was discharged from the clinic.

Figure 3: AP and lateral x-rays of the now 22-year-old female’s right hand 10 years post original injury. She was referred back to our clinic due to chronic wrist pain. The patient reported a gradual onset of pain, particularly pronounced on the medial border of the ulnar-carpus junction, radiating across her wrist and down her thumb, which began approximately five years prior when she was about 17. Imaging conducted during this revisit revealed notable deviations, including loss of radial inclination, decreased radial height compared to the ulna, separation at the distal radioulnar joint (DRUJ), and dorsal angulation. In light of the patient's evolving symptoms, it is evident that the dorsolateral aspect of her radius has not undergone consistent growth in tandem with the rest of the bone. Physeal arrest is acknowledged to manifest in approximately 7% of childhood distal radius fractures [1]. However, it is rare to have access to prior imaging for comparison. This case underscores the importance for physicians in achieving adequate reduction and for educating patients and parents in self-monitoring for continued surveillance.