Radius fracture in children | Distal radius fracture

Radius fracture in children

On the one hand, psychological care is becoming more important for children.On the other hand, children are still in the growth phase, which should also be taken into account in distal radius fractures: Bone growth starts from the epiphyseal fissure located in the metaphysis. An injury or relocation of the pineal fugue can lead to disturbed or even non-existent growth. In children, this becomes a problem especially if only one side is affected and the opposite side continues to grow “normally”.

Special attention is therefore paid to the control of the fracture, clarification of the question of involvement of the pineal fugue, and close follow-up examinations. In principle, children cope very well with fractures – unlike old patients, in whom the bone structure is usually already porous. Consequential damage is not to be expected with correct treatment.

However, children are not simply “little adults” and require special care. This begins immediately after the injury and ends with physiotherapy at the earliest. Classifications are extremely popular in surgery, and often a little complicated.

Unfortunately, the classification for the classification of distal radius fractures is no exception. However, it makes sense to distinguish between extra-articular, partial-intra-articular, and fully intra-articular joint fractures. The former refers to radius fractures that do not involve the joint at all.

The latter two describe a fracture with joint involvement, but once partially, i.e. with involvement of a small part of the joint surface, and once completely, with complete involvement of the joint surface. Since no one wants to write so much in surgery either, the individual fracture types were assigned letters depending on the fracture mode and severity: A-fractures refer to extra-articular fractures. B fractures are partial-intra-articular fractures, and C fractures are fully intra-articular fractures.

Depending on their severity, the fractures are assigned the numbers 1, 2, or 3: A1 thus describes an extra-articular distal fracture, with involvement of the ulna, and an intact radius. A2 is a regular, uncomplicated distal radius fracture with fracture of the radius. A3 describes a multipart fracture of the distal radius.

Note that in all three stages A1, A2, A3 the joint itself is not affected. Partial-intra-articular radius fractures are classified as follows: B1 is a fracture of the joint in the sagittal plane. The sagittal plane is, along with the horizontal and transverse planes, the plane that goes into the depth of the body.

If an arrow pierces an apple from the front, it pierces it in the sagittal plane. B2 denotes a fracture of the upper, dorsal edge of the joint surface. B3 is a fracture of the lower, palmar edge of the articular surface.

Finally, there remain the completely intra-articular radius fractures, which are designated by the letter C: C1 describes a fracture of the joint with metaphyseal involvement. In adults, the metaphysis is used to describe the end section of long tubular bones. A C2 fracture, like a C1 fracture, results in metaphyseal invoicing, but this time in several fragments.

Finally, C3 fracture is a complicated intra-articular fracture, with multiple fractures with no local relationship. Fractures cannot always be clearly classified in the AO classification, and of course there are also mixed forms. However, it makes the surgeons’ daily routine much easier, since the fracture has been classified in a clearly defined classification, and at least every treating physician in Germany knows directly what the fracture is about.