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Distal Ulnar Physeal Fracture

   

rare

physeal arrest >50% (Golz RJ, JPO 1991;11:318-326)

should be reduced to within 2mm of anatomic.  Reduction may be blocked by a tear in the joint capsule or interposition of the ECU or periosteum (Evans DL, CORR 1990;251:162-165)

follow closely for physeal arrest(loss of ulnar prominence, ulnar deviation

(Nelson, J Hand Surg 9A:164;1984)

ulnar physeal arrest leads to radial tethering, and bowing of the diaphysis and ulnar deviation with altered wrist mechanics. 

Distal Ulnar Physeal Fx Follow-up

Must follow closely due to high risk of ulnar physeal growth arrest. 

Ulnar Physeal arrest first evident on xray @6 months after injury.

Distal Physeal growth arrest may be treated with readial epiphysiodesis( Nelson OA, J Hand Surg AM 1984;9:164-171), corrective osteotomy of the radius, ulnar lengthening or acute ulnar lengthening with bone grafting.(Waters PM, JPO 1997;17:444-449)

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