Marked initial displacement predicts complications in physeal fractures of the distal radius: An analysis of fracture characteristics, primary treatment and complications in 109 patients

Figures & data

Figure A. Non-anatomic reduction of a dorsally displaced distal radial physeal injury in a 15-year-old boy (10% of dorsal displacement and 5% of dorsal angulation). B. Redisplacement in the cast (30% displacement and12% dorsal angulation), leaving a persistent malunion.

Risk factors for redisplacement of the distal radial physeal injury at 1 week and for complications (compartment syndrome, cast complications or growth arrest) according to logistic regression models

Characteristic	No. of patients	Redisplacement ≥ 20%			Dorsal re-angulation ≥ 10°			Complications
		OR	95% CI	p-value	OR	95% CI	p-value	OR	95% CI	p-value
Age (years)
< 10	27	1			1			1
10–13	41	0.5	0.11–1.9	0.3	0.3	0.06–1.5	0.1	1.4	0.39–5.4	0.6
> 13	41	0.3	0.07–1.3	0.1	0.2	0.04–1.1	0.06	2.1	0.56–8.1	0.3
Sex
F	41	1			1			1
M	68	3.8	0.95–15	0.06	3.2	0.7–14	0.1	1.2	0.4–3.5	0.8
Primary displacement
< 50%, < 20°	39	1			1			1
> 50% or > 20°	56	3.7	1.1–12	0.03	4.5	1.1–18	0.04	19	6.6–56	< 0.001
Primary reduction
Anatomic	93	1			1			1
Non-anatomic	16	4.4	1.3–15	0.02	3.5	0.9–14	0.07	0.3	0.07–1.3	0.1
Cast index
< 0.70	12	1			1			1
0.70–0.79	56	0.4	0.07–2.3	0.3	0.6	0.09–4.6	0.7	0.5	0.1–2.2	0.3
> 0.79	32	0.8	0.13–4.8	0.8	0.8	0.1–5.8	0.8	0.7	0.1–3.8	0.7