Physeal arrest of the distal radius with midcarpal instability

Discussion:

Case of distal radius extraphyseal fracture treated with Kirschner wire fixation, complicated by premature physeal closure with a bony bar on the radial side, exactly where the initial pins were placed. K-wire related complications are migration of the pins, superficial infections, and damage to the physeal plates. Physeal arrest of the distal radius may alter, impair, or completely stop the growth of the bone. A physeal bar between the metaphysis and epiphysis in the local region of the growth plate can cause progressive deformities and functional problems of the wrist. It is advisable in adolescents with distal radius fractures treated with pin fixation to be followed up with radiographs of the wrist after approximately one year to document normal growth of the distal radius. CT and MRI are useful for detecting the size and position of the bony bridge and information related to cartilage abnormalities.

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