Treatment of Displacement of the Proximal Radial Epiphysis

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Abstract
1. Displacement of the proximal radial epiphysis is a rare injury, probably the result of a fall backward or to the side on the outstretched hand with the forearm in supination. 2. Thirty children with displaced proximal radial epiphyses who were between six and thirteen years of age at the time of injury were studied. Eighty per cent had displacement of 60 degrees or more. 3. The treatment should be closed reduction if possible but if this fails, as was frequently the case in this series, open reduction without internal fixation should be performed. 4. Age at the time of injury seemed to have a definite influence in the final outcome after open reduction, the children under ten years of age had a higher percentage of good and excellent results than did those in the older age group. 5. Bone spurs on the proximal end of the radius, ulna, or both bones were noted in six of the eight children who were twelve years old or older at the time of injury and who were treated by open reduction. These children tended to have greater restriction of rotation at follow-up examination. 6. Flexion or extension were rarely limited; rotation was limited in 75 per cent of the cases. Pronation, the motion most frequently involved, was limited in twenty-one of the twenty-nine elbows. Eighteen of the twenty-nine patients who had end-result evaluation had normal or nearly normal elbow motion with minimum deformity.

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