とう骨遠位骨端線損傷の一例

Abstract

We report a case in which a bone bridge was formed at the distal radial epiphysis after an intra-articular comminuted fracture. The patient was a 7 year-old boy who sustained a comminuted intra-articular fracture (epiphyseal injury) to his left distal radius after falling from a height of 4 meters'. He received closed reduction and percutaneous pinning. He showed a malunited intra-articular fracture and bone bridge formation at the distal radial epiphysis on his first visit to our clinic. Before surgery, the ROM of the left wrist was 15° in extension and 30° in flexion. X-p films revealed the malunited intra-articular fracture with bone bridge at the distal radial epiphysis. There was no radio-lunate motion on X-p films and intra-articular adhesion of the radio-lunate joint was suspected by arthrogram. We corrected the malunited intra-articular fracture by reducing malunited fragments with resection of the bone bridge and a succeeding free fat graft. One year after surgery, growth of the distal radial epiphysis was 4mm in the left radius and 5mm in the right. Two years after surgery, extension improved to 55° and flexion improved to 70°.