From the Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD (Dr. Abzug), the Department of Orthopaedic Surgery, University of Cincinnati College of Medicine, Cincinnati, OH (Dr. Little), and the Department of Orthopaedic Surgery, Temple University School of Medicine, Philadelphia, PA (Dr. Kozin).
J Am Acad Orthop Surg. 2014 Jun;22(6):381-9. doi: 10.5435/JAAOS-22-06-381.
Fractures of the distal radius are among the most common pediatric fractures. Although most of these fractures heal without complication, some result in partial or complete physeal arrest. The risk of physeal arrest can be reduced by avoiding known risk factors during fracture management, including multiple attempts at fracture reduction. Athletes may place substantial compressive and shear forces across the distal radial physes, making them prone to growth arrest. Timely recognition of physeal arrest can allow for more predictable procedures to be performed, such as distal ulnar epiphysiodesis. In cases of partial arrest, physeal bar excision with interposition grafting can be performed. Once ulnar abutment is present, more invasive procedures may be required, including ulnar shortening osteotomy or radial lengthening.
桡骨远端骨折是儿童中最常见的骨折之一。尽管大多数此类骨折可愈合而无并发症，但有些会导致部分或完全骺板停止发育。通过避免骨折管理期间的已知危险因素（包括多次尝试骨折复位），可以降低骺板停止发育的风险。运动员可能会在桡骨远端骺板上施加大量的压缩和剪切力，使骺板容易停止发育。及时发现骺板停止发育，可以进行更可预测的手术，如尺骨远侧骺板融合术。在部分停止发育的情况下，可以进行骺板切除和植骨。一旦出现尺骨抵接，可能需要更具侵袭性的手术，包括尺骨缩短截骨术或桡骨延长术。
