Presentation
Fall on an outstretched hand; off BMX cycle whilst doing a jump with obvious wrist deformity
Patient Data
Salter-Harris type 2 fracture of distal radius: The distal radial fracture appears comminuted with extension into the physis.
Transversely oriented displaced dorsoradial angulated fractures of the left distal radial metaphysis and left distal ulnar diametaphysis.
The distal ulna fracture remains clear of the distal physis.
Congruent distal radioulnar joint. Normal carpal alignment.
10 days post-fracture:
Overlying cast in situ. Two K-wires transfix the comminuted distal radius. Salter-Harris II fracture in near anatomical alignment.
No metalware complication.
Stable alignment of transverse fracture of the distal ulna metadiaphysis with radial angulation of the distal fracture fragment.
Sclerosis of fracture margins in keeping with interval healing.
4 weeks post-fracture:
Salter-Harris II fracture in near anatomical alignment. No metalware complication. Stable alignment of the distal ulna diaphysis fracture with radial and volar angulation of the distal fracture fragment.
Sclerosis of fracture margins and surrounding periosteal reaction in keeping with interval healing.
Case Discussion
This radiology series demonstrates the first two stages of normal fracture healing: inflammatory and reparative stage. The third stage been remodeling 1.
Type 2 Salter-Harris fractures the most common type of Salter-Harris fracture. They are a transverse fracture through the growth plate and an oblique or vertical fracture through the metaphysis 2. As with most Salter-Harris type 2 fractures, this fracture required OIF.
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