8/27/2023 0 Comments Greenstick fracture distal radius![]() Extension of the wrist at the time of injury causes the distal fragment to be displaced dorsally (posteriorly). The most common mechanism of injury is a fall on an outstretched hand. Up to 13% incidence of other arm injuries (hand, forearm, elbow) occur on the same side. Metaphyseal fractures have a peak incidence during the adolescent growth spurt (girls aged 11-12 years, boys 12-13 years) due to weakening through the metaphysis with rapid growth. How common are they and how do they occur? ![]() The ulna may have a complete fracture, greenstick fracture, or a plastic deformityģ. The radius is commonly a complete fracture. Most complete metaphyseal fractures involve both the radius and ulna. See fracture education module for more informationĬomplete: A fracture that extends through both cortices. Although there is a disruption to the cortical bone, the integrity of the bone is minimally compromised, resulting in different patient management from other fractures bone involvement (radius only, both radius and ulna)īuckle injury: Compression injury failure of bone resulting in the cortex bulging outwards (unilateral or bilateral).displacement (whether undisplaced or displaced).No follow-up by GP or fracture clinic is required.Ĭomplete - undisplaced or minimally displaced fracturesĬlosed reduction with immobilisation in below-elbow cast for 6 weeksįor young children, above-elbow casts may be appliedĭistal radius metaphyseal fractures can be classified according to: Provide parent with buckle injury fact sheet. What are the potential complications associated with this injury?īelow-elbow fibreglass/plaster backslab or removable wrist splint for 3 weeksĬheck that both cortices are intact on the anteroposterior (AP) and lateral x-ray.What is the usual ED management for this fracture?.Do I need to refer to orthopaedics now?.When is reduction (non-operative and operative) required?.What radiological investigations should be ordered?.How common are they and how do they occur?.A precise classification of fracture type at the time of diagnosis would identify a smaller subset of patients that require follow-up.Distal radius and / or ulna metaphyseal fractures - Fracture clinics Complete fractures of the distal radius are uncommon in children, and highly unstable. Greenstick fractures are unstable and continue to displace after 2 weeks. īuckle fractures are stable and do not require follow-up. On average, the complete fractures displaced 9 degrees. The greenstick fractures displaced 5 degrees on average, and continued to displace after the first 2 weeks. The lateral angulation of the buckle fractures did not change importantly throughout the treatment. The greenstick fractures had more complications than the buckle fractures. Only 1 of 311 follow-ups led to an active intervention. The fracture type was determined from the initial radiographs and the angulation on the lateral films was noted. The medical records of 305 distal radius fractures in patients aged less than 16 years treated at our institution in 2006 were reviewed, and any complications were noted. The stability of greenstick and buckle fractures of the distal radius was assessed by comparing the lateral angulation radiographically. We investigated the degree to which the follow-up visits reveal complications and lead to change in management. Numerous follow-up visits for wrist fractures in children are performed without therapeutic consequences.
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