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Purpose <p>There is limited evidence to support decision-making in adolescents with metaphyseal distal radius fractures. This study aims to review injury patterns, treatments, and clinical outcomes in this age group.</p> Methods <p>Patients aged 11–16&#xa0;years presenting with metaphyseal distal radius fractures were obtained from our institutional trauma database. Radiographs and records were reviewed to obtain injury details, management, complications, and long-term sequelae.</p> Results <p>One hundred and five fractures were included. Mean age was 12.6&#xa0;years and 79% occurred in males. 75.2% were angulated and 24.8% off-ended. The median initial angulation was 22.1° (2.3–46.7), and the majority were dorsally displaced (74.3%). Emergent management for 91 (86.7%) patients was surgical with either manipulation under anaesthesia (MUA) and cast in theatre (59.3%), Kirschner wire (K-wire) fixation (35.8%), or open reduction internal fixation (ORIF) (3.3%). Fourteen patients were initially managed non-operatively, and 71.4% of these re-displaced requiring surgery. There was no statistical difference in final angulation of fractures managed with MUA and cast or fixation (5.35 vs. 5.5°, respectively). Complications occurred in 14.3%, including two cases of osteomyelitis. Twenty cases had final angulation of greater than 9°, but none underwent corrective osteotomy.</p> Conclusion <p>In adolescents, metaphyseal distal radius fractures have a higher risk of early re-displacement when not reduced in theatre; however, both casting and fixation resulted in similar final angulation. Complications were common at 14.3%, but only occurred in those that underwent fixation. Few long-term issues were observed in those treated in cast, even with up to 20° of residual angulation.</p>

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Metaphyseal distal radius fractures in adolescents: is closed reduction and casting sufficient for most?

  • 期刊论文

  • 发表日期：

    2025年2月7日

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  • Daniel William Hancock,
  • Joe Jordan Thomas Barrett-Lee,
  • Ahmed Mohamed Ahmed Abdellatif,
  • Sophie White,
  • Perry Liu,
  • Darren Roberts

摘要

Purpose

There is limited evidence to support decision-making in adolescents with metaphyseal distal radius fractures. This study aims to review injury patterns, treatments, and clinical outcomes in this age group.

Methods

Patients aged 11–16 years presenting with metaphyseal distal radius fractures were obtained from our institutional trauma database. Radiographs and records were reviewed to obtain injury details, management, complications, and long-term sequelae.

Results

One hundred and five fractures were included. Mean age was 12.6 years and 79% occurred in males. 75.2% were angulated and 24.8% off-ended. The median initial angulation was 22.1° (2.3–46.7), and the majority were dorsally displaced (74.3%). Emergent management for 91 (86.7%) patients was surgical with either manipulation under anaesthesia (MUA) and cast in theatre (59.3%), Kirschner wire (K-wire) fixation (35.8%), or open reduction internal fixation (ORIF) (3.3%). Fourteen patients were initially managed non-operatively, and 71.4% of these re-displaced requiring surgery. There was no statistical difference in final angulation of fractures managed with MUA and cast or fixation (5.35 vs. 5.5°, respectively). Complications occurred in 14.3%, including two cases of osteomyelitis. Twenty cases had final angulation of greater than 9°, but none underwent corrective osteotomy.

Conclusion

In adolescents, metaphyseal distal radius fractures have a higher risk of early re-displacement when not reduced in theatre; however, both casting and fixation resulted in similar final angulation. Complications were common at 14.3%, but only occurred in those that underwent fixation. Few long-term issues were observed in those treated in cast, even with up to 20° of residual angulation.