Distal Ulnar Physeal Fracture S59.009A

Distal Ulnar Physeal Fracture ICD-10

• S59.009A Unspecified physeal fracture of lower end of ulna, unspecified arm, initial encounter for closed fracture
• See all Ulna physeal ICD-10 Codes

Distal Ulnar Physeal Fracture Etiology, Natural History

• 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)