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HOME > J Musculoskelet Trauma > Volume 34(2); 2021 > Article
Review Article Pediatric Fractures around the Wrist
Gihun Kim, Kun-Bo Park
Journal of Musculoskeletal Trauma 2021;34(2):80-86.
DOI: https://doi.org/10.12671/jkfs.2021.34.2.80
Published online: April 30, 2021
Division of Pediatric Orthopedic Surgery, Severance Children’s Hospital, Yonsei University College of Medicine, Seoul, Korea

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Abstract

Fractures around the wrist are the third most common fracture among all pediatric fractures. Furthermore, distal radius fractures, a type of wrist fracture, are the most common fractures in children. Understanding pediatric fractures around the wrist is very important considering their prevalence. There is a specific belief that pediatric fractures can heal easily because of remodeling, but not all fractures can heal without proper treatment. Complications such as growth problems, nonunion can occur if the fracture is not treated properly. This paper reviewed recent articles about distal radius fractures, Galeazzi-equivalent fractures, and carpal bone fractures, including scaphoid fractures in children and adolescents. Successful treatment can be achieved without complications when an accurate diagnosis and proper non-surgical or surgical treatment are performed based on this article.


J Korean Fract Soc. 2021 Apr;34(2):80-86. Korean.
Published online Apr 23, 2021.
https://doi.org/10.12671/jkfs.2021.34.2.80
Copyright © 2021 The Korean Fracture Society. All rights reserved.
Review

Pediatric Fractures around the Wrist

Gihun Kim, M.D. and Kun-Bo Park, M.D.
    • Division of Pediatric Orthopedic Surgery, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • Correspondence to: Kun-Bo Park, M.D.. Division of Pediatric Orthopedic Surgery, Severance Children's Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Tel: +82-2-2228-2180, Fax: +82-2-363-1139, Email: pedoskbp@yuhs.ac
Received February 28, 2021; Revised March 02, 2021; Accepted March 02, 2021.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Fractures around the wrist are the third most common fracture among all pediatric fractures. Furthermore, distal radius fractures, a type of wrist fracture, are the most common fractures in children. Understanding pediatric fractures around the wrist is very important considering their prevalence. There is a specific belief that pediatric fractures can heal easily because of remodeling, but not all fractures can heal without proper treatment. Complications such as growth problems, nonunion can occur if the fracture is not treated properly. This paper reviewed recent articles about distal radius fractures, Galeazzi-equivalent fractures, and carpal bone fractures, including scaphoid fractures in children and adolescents. Successful treatment can be achieved without complications when an accurate diagnosis and proper non-surgical or surgical treatment are performed based on this article.

Keywords
Wrist fracture, Distal radius fracture, Galeazzi-equivalent fracture, Scaphoid fracture, Nonunion, Physeal arrest

Figures

Fig. 1
Manual reduction of a displaced distal radius fracture (A → B → C → D). The dorsally displaced distal bone fragment was extended and pulled until the distal bone fragment's dorsal fracture surface contacted the dorsal fracture surface of the proximal bone fragment and was then bent to the palmar side to reduce.

Fig. 2
Cast index=b/a.6) If the cast index is greater than 0.7, the possibility of re-displacement is high.

Fig. 3
(A) Distal radius physeal fracture swith Salter–Harris type I. (B) After eight months, the physeal gap was narrowed, and physeal arrest is suspected. (C) After one year nine months, the ulnar was longer than the radius due to physeal arrest of the distal radius physis (ulnar impaction). (D) Ulnar shortening was performed. The residual growth of the distal ulnar bone was expected to be about 1 cm. Complete epiphysiodesis of the distal radial and ulnar growth plate was performed to prevent further deformity.

Fig. 4
Galeazzi fracture (A, B) and Galeazzi-equivalent fracture (C, D). Unlike a Galeazzi fracture-dislocation, the distal radio-ulnar joint is preserved in the Galeazzi-equivalent fracture.

Fig. 5
A 15-year-old boy's scaphoid fracture (A) was treated by percutaneous screw fixation (B). The scaphoid nonunion (C) was observed six months after surgery. There was no evidence of bony sclerosis, necrosis, or cyst on magnetic resonance imaging (D), and the subtle bony union was noted on the medial side. Additional cast fixation was performed for six weeks, and then complete healing (E) was observed.

Notes

Financial support:None.

Conflict of interests:None.

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    Pediatric Fractures around the Wrist
    J Korean Fract Soc. 2021;34(2):80-86.   Published online April 30, 2021
    DOI: https://doi.org/10.12671/jkfs.2021.34.2.80
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