Outcome of distal tibia physeal fractures: a review of cases as related to risk factors.

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Abstract

[Indexed for MEDLINE] 13. Injury. 2009 Jun;40(6):631-7. doi: 10.1016/j.injury.2009.01.104. Epub 2009 Apr 24. Bone bruising of the distal forearm and wrist in children. Sferopoulos NK(1). Author information: (1)Department of Paediatric Orthopaedics, Aristotle University of Thessaloniki, P. Papageorgiou 3, 54635 Thessaloniki, Greece. sferopoulos@in.gr Bone bruising represents a new category of bone injury that can only be demonstrated by magnetic resonance imaging (MRI) with fat suppression. This study proposed the nature of non-radiographically evident injuries of the distal radius and wrist in children whose symptoms did not resolve after 5 weeks. We aimed to describe and classify the lesions and delineate the importance and potential complications of the injuries. Bone bruising was diagnosed in 20 patients (mean age: 11.6 years; range: 9-13 years). Bone bruises were classified according to anatomical location and whether they were solitary lesions or were combined with other injuries. Injuries of the distal radius were classified according to location: type 1 was localised to the metaphysis, close to the physeal plate; type 2 involved both the metaphysis and diaphysis; and type 3 extended on both sides of the distal radial growth plate. The type 1 injuries were consistent with complete, un-displaced Salter-Harris type I fractures, whilst type 3 lesions were potentially Salter-Harris type V injuries. Our data indicate that an MRI should be considered for a child with an injury to the distal radius or wrist whose symptoms do not resolve after 5 weeks of immobilisation. DOI: 10.1016/j.injury.2009.01.104