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Posttraumatic distal radius growth arrest as a cause of the development of distal radioulnar joint instability in children
- Authors: Proshchenko Y.N.1, Semenov S.Y.1,2
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Affiliations:
- H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery
- North-Western State Medical University named after I.I. Mechnikov
- Issue: Vol 9, No 1 (2021)
- Pages: 87-94
- Section: Exchange of experience
- URL: https://journals.eco-vector.com/turner/article/view/42558
- DOI: https://doi.org/10.17816/PTORS42558
- ID: 42558
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Abstract
BACKGROUND: The distal radial physis is involved in the injury process in approximately 15% of distal radius fractures. Distal radius physeal arrest and the normal functioning of the distal ulna growth lead to lengthening and dislocation of the head of the ulna in the distal radioulnar joint (DRUJ). These changes, in turn, lead to pain syndrome and forearm dysfunction, which is a manifestation of DRUJ instability.
AIM: This study aims to evaluate the results of a study of pediatric patients with traumatic DRUJ instability.
MATERIALS AND METHODS: An analysis of the results of the examination of 11 children aged from 13 to 17 years with traumatic type DRUJ instability due to the distal radius growth arrest.
RESULTS: According to the X-ray examination data, all children showed closure of the distal growth zone of the radius and ulnar positive variant (ulna +). The shortening of the radius was calculated. Also, the time interval between the injury and the discovery of the wrist joint pathology was estimated. All types of radius fractures with growth plate involvement can cause physeal arrest, leading to a DRUJ instability. The interval from the acute wrist injury with damage to the distal radius growth zone to develop clinical manifestations of a DRUJ instability is 2.4 years on average.
CONCLUSION: The development of this type of traumatic DRUJ instability is typical only in children since changes occur in the presence of an active growth zone and are associated with previous fractures of the distal radius. Therefore, a long-term dispensary observation by a traumatologist-orthopedist is necessary for patients with this pathology.
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About the authors
Yaroslav N. Proshchenko
H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery
Email: yar2011@list.ru
ORCID iD: 0000-0002-3328-2070
SPIN-code: 6953-3210
MD, PhD
Russian Federation, 64-68 Parkovaya str., Pushkin, 196603, Saint PetersburgSergey Yu. Semenov
H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery; North-Western State Medical University named after I.I. Mechnikov
Author for correspondence.
Email: sergey2810@yandex.ru
ORCID iD: 0000-0002-7743-2050
SPIN-code: 8093-3924
MD, PhD student
Russian Federation, 64-68 Parkovaya str., Pushkin, 196603, Saint Petersburg; Saint PetersburgReferences
- Andersson JK, Lindau T, Karlsson J, Friden J. Distal radioulnar joint instability in children and adolescents after wrist trauma. J Hand Surg Eur. 2014;39(6):653–661. doi: 10.1177/1753193413518707
- Carsi B, Abril J, Epeldegui N. Longitudinal growth after nonphyseal forearm fractures. J Pediatr Orthop. 2003;23(2):203–207
- Shvedovchenko IV. Lechenie detey s vrozhdennymi porokami razvitiya verhnih konechnostey Travmatologiya i ortopediya: rukovodstvo dlya vrachey. In 4 vol. Vol. 2: Travmy i zabolevaniya plechevogo poyasa i verhney konechnosti. Ed. by N.V. Kornilov, Ye.N. Gryaznukhin. Saint Petersburg: Hippocrates Publ; 2005. (In Russ.)
- Sosnenko ON, Pozdeev AP. Surgical treatment of children with Madelung deformity. Pediaric traumatology, orthopaedics and reconstructive surgery. 2014;2(4):15–19. (In Russ.). doi: 10.17816/PTORS2415-19
- Sendryoi M, Sim FH. Atlas of Clinical Orthopedics. Moscow: Panfilova Publ; 2014. (In Russ.)
- Vanheest A. Wrist deformities after fracture. Hand Clin. 2006;22(1):113–120. doi: 10.1016/j.hcl.2005.11.001
- Little JT, Klionsky NB, Chaturvedi A, et al. Pediatric distal forearm and wrist injury: An imaging review. RadioGraphics. 2014;34(2):472–490. doi: 10.1148/rg.342135073
- Schneiders W, Biewener A, Rammelt S, et al. Die distale Radiusfraktur: Korrelation zwischen radiologischem und funktionellem Ergebnis. Unfallchirurg. 2006;109(10):837–844. (In German). doi: 10.1007/s00113-006-1156-8
- Proshchenko YaN. Mechanism for the occurrence of traumatic instability in distal radioulnar joint in children. Vestnik of exoerimental and clinical surgery. 2015;8(2):229–234. (In Russ.). doi: 10.18499/2070-478X-2015-8-1-229-234
- Ellanti P, Harrington P. Acute ulnar shortening for delayed presentation of distal radius growth arrest in an adolescent. Case Rep Orthop. 2012;2012:1–3. doi: 10.1155/2012/928231
- Gauger EM, Casnovsky LL, Gauger EJ, et al. Acquired upper extremity growth arrest. Orthopedics. 2017;40(1):95–103. doi: 10.3928/01477447-20160926-07
- Moon DK, Park JS, Park YJ, Jeong ST. Simultaneous correction of radius and ulna for secondary ulnar impaction syndrome with radial physeal arrest in adolescent: A case report and review of literatures. Int J Surg Case Rep. 2018;50(1)144–149. doi: 10.1016/j.ijscr.2018.07.022
- Abzug JM, Little K, Kozin SH. Physeal arrest of the distal radius. J Am Acad Orthop Surg. 2014;22(6):381–389. doi: 10.5435/JAAOS-22-06-381
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