Posttraumatic distal radius growth arrest as a cause of the development of distal radioulnar joint instability in children

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.