Pedrazzini Alessio, Bastia Paolo, Bertoni Nicola, Pedrabissi Bianca, Simo Henry Claudel Yewo, Medina Vanni, Ceccarelli Francesco, Pogliacomi Francesco
SSD Ortopedia e Traumatologia , Ospedale Oglio Po, Casalmaggiore (CR).
Acta Biomed. 2018 Dec 18;90(1-S):169-174. doi: 10.23750/abm.v90i1-S.7999.
Radius and ulna fractures are the most common long bone fractures in children and adolescents. The majority of these injuries involve the distal metaphyseal portion of the radius associated or not to physeal plate injuries. Because of the high remodelling potential of the distal radius in growing children most injuries heal without complication after closed reduction and immobilization in a long arm cast. Nonunions of closed distal radius fracture are an extremely rare occurrence especially in paediatric population. Methods: In this report, we describe a rare case of distal radius fracture nonunion in a 15-years old male rider treated conservatively with cast immobilization. Eight months later he underwent surgical closed reduction and fixation with kirschner wire and cannulated screw. Results: Follow-up at 2 years showed satisfying radiological and functional outcomes. The patient ultimately returned to ride 3 months following surgery. Conclusions: Nonunion is rarely seen in distal radius fractures in healthy children and adolescents, and there are few studies in the literature. Treatment of the nonunion must be individualized and the results are not entirely predictable.
桡骨和尺骨骨折是儿童和青少年中最常见的长骨骨折。这些损伤大多数累及桡骨远端干骺端部分，伴或不伴有骨骺板损伤。由于生长中的儿童桡骨远端具有很高的重塑潜力，大多数损伤在闭合复位并用长臂石膏固定后可顺利愈合且无并发症。闭合性桡骨远端骨折不愈合极为罕见，尤其是在儿科人群中。方法：在本报告中，我们描述了一例15岁男性骑手桡骨远端骨折不愈合的罕见病例，该病例最初采用石膏固定保守治疗。八个月后，他接受了闭合复位手术，并用克氏针和空心螺钉进行固定。结果：两年后的随访显示，影像学和功能结果均令人满意。患者最终在术后3个月恢复骑行。结论：健康儿童和青少年的桡骨远端骨折很少出现不愈合，且文献中相关研究较少。骨折不愈合的治疗必须个体化，其结果并非完全可预测。
