How long does it to achieve sagittal realignment of the displaced epiphysis in Salter-Harris type II distal radial fracture when treated by manual reduction?

Abstract

This study aimed to investigate how long it takes for the dorsally displaced distal radial epiphysis to achieve realignment. We retrospectively reviewed 56 patients with dorsally displaced Salter-Harris type II distal radial epiphyseal fractures who were aged ≤15 years at the time of injury. All fractures were treated with closed reduction and immobilised using a sugar tong splint for 6 weeks. We evaluated the change in the displaced epiphysis position (%) until 12 weeks and the long-term clinical and radiological outcomes. We analysed significant differences in demographic factors and epiphyseal displacement according to the required period for epiphyseal realignment. The estimated area of the receiver operating characteristics (ROC) curve was calculated, and cut-off values were suggested to predict the required period for epiphyseal realignment. Sixteen (28.6%) and 42 (75%) patients achieved realignment of the epiphysis within 8 and 12 weeks, respectively. The cut-off values of 13.1 and 22.9% displacement at the 1-week follow-up were the best predictors of epiphyseal realignment within 8 and 12 weeks, respectively. Patients with a residual displacement of up to 51.3% in the sagittal plane at the 1-week follow-up achieved complete realignment of the epiphysis at the 6-month follow-up. From this study, we could predict the timing of epiphyseal realignment, and expect epiphyseal realignment even if re-displacement occurred up to 51.3% at the 1-week follow-up.

Keywords:

• Sagittal realignment
• epiphysis
• Salter-Harris type II
• distal radial fracture
• manual reduction
• realignment

Level of evidence:

• IV
• case series

Acknowledgments

We would like to thank Editage (www.editage.co.kr) for editing and reviewing this manuscript in the English language.

Ethical approval

We obtained approval from the Chungnam National University Hospital Institutional Review Board (IRB No.: CNUH 2021-05-050).

Informed consent

Informed consent was obtained from all individual participants included in the study.

Author contributions

Seung Hoo Lee and Hyun Dae Shin: conception of the work, the acquisition, analysis, and interpretation of data for the work, drafting of the work and revising it critically for important intellectual content, final approval of the version to be published, and agreement to be accountable of all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Soo Min Cha and Eun-Seok Choi: acquisition, analysis, and interpretation of data for the work, drafting of the work, final approval of the version to be published, and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korean Government (Ministry of Science and ICT) under grant number 2019R1C1C100396712.