Outcomes of Epiphysiodesis About the Distal Radius and Distal Ulna

Abstract

Background:

Wrist fractures comprise nearly 30% of all fractures in children. Fractures that damage the distal radius and/or distal ulnar growth plates may require epiphysiodesis to prevent skeletal deformity and/or length discrepancy. Epiphysiodesis is commonly used to correct leg-length discrepancies in children but has not been extensively studied for its use on the distal radius and ulna. The purpose of this study is to present the outcomes of epiphysiodesis procedures about the distal radius and/or distal ulna.

Methods:

A retrospective review identified pediatric patients (<18 years) who underwent a distal radius and/or distal ulna epiphysiodesis over a 12-year period. Data collection included patient demographics, mechanism of injury, physeal arrest cause, time to complete physeal closure, return to activities, and complications. Associations between patient characteristics and outcomes were determined using univariate regressions.

Results:

Thirty-four patients with an average age of 13 years (SD: 1 year; range: 10-16 years) were identified. Initial physeal arrest was caused by a fracture in 30 (88.2%) patients. Seventeen (50.0%) epiphysiodesis procedures involved only the distal ulna, 2 (5.9%) only the distal radius, and 15 (44.1%) were performed concomitantly in both. The median time to physeal closure was 8.4 weeks (interquartile range [IQR]: 7.1-10.9 weeks). Four patients (11.8%) experienced transient complications after distal ulnar epiphysiodesis. No complications were identified following distal radius epiphysiodesis. All physes closed completely following the epiphysiodesis procedures.

Conclusions:

Epiphysiodesis of the distal radius and/or distal ulna is a well-tolerated and beneficial procedure. The physis completely closes around 8 weeks following the procedure. This series did not identify any cases that required a return to the operating room due to an incomplete closure of the physis.