Department of Orthopaedic Surgery.
Department of Critical Care Medicine, Iwate Medical University, Idaidori, Yahaba-Cho, Shiwa-Gun.
J Pediatr Orthop B. 2022 Sep 1;31(5):471-478. doi: 10.1097/BPB.0000000000000963. Epub 2022 Mar 31.
The distal part of the forearm is divided into the physis, metaphysis, diaphyseal metaphyseal junction (DMJ) and diaphysis. The treatment of radial DMJ fractures is challenging because this region has diaphyseal characteristics. We speculated that the stability of metaphyseal fractures could vary depending on their proximity to the DMJ or physis. Our study aimed to investigate the stability of pediatric distal radius fractures in the physis, metaphysis and DMJ. Ninety-five patients were classified into three groups: group D, fracture line located within 1/2 of the width of the radius (WOR) from the physis; group M, fracture line located between 1/2 and 1 WOR from the physis; and group P, fracture line located between 1 and 2 WOR from the physis. We measured sagittal angulation and coronal angulation. A correction loss of less than 9° was defined as a 'stable reduction' outcome and one greater than 10° as a 'loss of reduction' outcome. The correction losses for sagittal angulation were significantly greater in groups M and P than in group D. The correction losses for coronal angulation were significantly greater in group P than in groups D and M. The incidence of 'loss of reduction' outcomes was significantly higher in groups M and P than in group D. The proximal segments of distal radial metaphyseal and DMJ fractures showed less angular stability than distal segments.
前臂的远端部分分为骺、干骺端、骨干骺端交界处（DMJ）和骨干。桡骨 DMJ 骨折的治疗具有挑战性，因为该区域具有骨干特征。我们推测，骺端骨折的稳定性可能因靠近 DMJ 或骺线而有所不同。我们的研究旨在探讨骺、干骺端和 DMJ 处儿童桡骨远端骨折的稳定性。95 名患者被分为三组：D 组，骨折线位于骺线 1/2 WOR 以内；M 组，骨折线位于骺线 1/2 到 1 WOR 之间；P 组，骨折线位于骺线 1 到 2 WOR 之间。我们测量矢状面成角和冠状面成角。小于 9°的矫正丢失定义为“稳定复位”结果，大于 10°的矫正丢失定义为“复位丢失”结果。M 组和 P 组的矢状面成角矫正丢失明显大于 D 组。P 组的冠状面成角矫正丢失明显大于 D 组和 M 组。M 组和 P 组的“复位丢失”发生率明显高于 D 组。桡骨远端干骺端和 DMJ 骨折的近段较远端的角度稳定性差。
