Journal of Musculoskeletal Trauma

Conservative Treatment of Moderately Displaced S-H type II Injury in Distal Radius : a Report of 5 Cases: Tai Seung Kim, Ye Soo Park, Duck Keun Kim, Jae Lim Cho; J Korean Soc Fract 1997;10(3):718-725. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.718

Epiphyseal injury in children is most frequently developed in distal radius. Type II injury in Salter Harris classification is known to be most common. In most cases of Salter Harris type II injury, the conservative treatment such as closed reduction and cast immobilization is reported to be effective. However, in moderately displaced epiphyseal injury, repeated manipulation would give further damage to the epiphyseal plate and then results in premature closure of the epiphyseal plate and growth arrest. We experienced five cases of moderately displaced S-H type II injury of distal radius, which had been reduced immediately after injury by closed method at privatic clinic, but redisplaced. We did not try to get realignment because it had passed 6 to 14 days since fracture occurred. Rather, we thought maintaining of present position could be best. After the conservative treatment for five cases, we have evaluated follow up results over one year. The results were excellent. We hereby report it with literature review.

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Epiphyseal Fractures of the Distal Radius in the Children
Hui Taek Kim, Myung Soo Youn, Jong Seo Lee, Young Jun Choi, Yoon Jae Seong
Journal of the Korean Fracture Society.2008; 21(3): 225. CrossRef

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Wrist Injury in Juvenile Gymnasts: Choong Gil Lee, Jin Woo Kwon, Jae Hyum Park, Sang Hoon Lee, Wan Eup Kim, Eun Sik Shin; J Korean Soc Fract 1996;9(4):1125-1130. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.1125

Abstract PDF: In the adolescent gymnasts, recent studios have shown that wrist is particularly vulnerable to chronic stress. In the immature skeleton, growth plate is especially vulnerable to acute or chronic trauma since the joint capsule and ligamentous structures are strong. The purpose of this study is to report the frequency, finding of radiologic abnormalities and the type of sports to cause wrist pain. The authors examined 26 adolescent gymnasts, 20 males and 6 females. The age range was 11 years 10 months to 17 years 5 months for males and 11 years 9 months to 34 years 4 months for females. The results were as follows; 1. The radiologic abnormalities were found in 23 cases(88%), 19 males and 4 females. 2. Wrist pain was most frequently csused by pommel horse exercise in males and by floor exercise in females. 3. Among 23 cases, 18 showed widening of distal radial growth plates and irregularities of the margins of the growth plate(15 cases were bilateral). Widening of distal ulna growth plates were combineti in six cases, ulna styloid process fracture in 3 cases and radial styloid process fracture in 1 case. 4. Among 23 cases, 5 cases showed widening of distal radial metaphysis and increased ulnar tilting.

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Clinical Analsis of the Salter-Harris Type II Epiphyseal Injury of the Distal Femur: Ik Dong Kim, Poong Taek Kim, Byung Chul Park, Young Goo Lyu, Soo Ill Han; J Korean Soc Fract 1990;3(2):189-196. Published online November 30, 1990; DOI: https://doi.org/10.12671/jksf.1990.3.2.189

Abstract PDF: Although most of distal femoral epiphyseal fracture is Salter-Harris type II, its prognosis is not uniformly good and poses several problems such as limb length discrepancy, varus or valgus angulation and limitation of knee motion. Authors experienced 9 cases of Salter-Harris type II distal femoral epiphyseal injuries who were treated at Kyoungpook National University Hospital from January, 1982 to June, 1987, All were foloowed for an average of two years and ten months (range, one to seven years) and analysed clinically. The results abtained were as follows. 1. 5 out of 9 cases between 16 and 18 years of age. 2. Significant limb length discrepancy beyond 2cm occurred in only 1 case, lengthening of 0.6cm in 2 cases and less than 1.0cm shortening in 6 cases. 3. Valgus angulation of 10 degress or less occurred in 5 cases and 20 degrees of valgus defromity in 1 case. Varus angulation of 5 degrees or less occurred in 2 cases and of 6 degrees in 1 case. 4. Limitation of knee motion was not observed in all cases. 5. Salter-Harris type II epiphyseal plate injuries does not always carry a good prognosis especially when involving the distal femoral epiphsis. It can bring about growth acceleration or deceleration and angular deformity. Early and anual follow-up until cessation of growth is mandatory.

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