PMC6170786_01
A, Gross picture of left distal forearm at the time of injury demonstrate a Gustilo-Anderson type II open fracture. B, Anterioposterior (AP) and lateral radiopraphs of the left wrist at the time of injury demonstrate a Salter-Harris type I physeal fracture of the distal radius and metaphyseal transverse fracture of the distal ulna.
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Radiographs had presented epiphyseal plate separation and dorso-radial displacement of distal fragment of radius (Salter-Harris type I injury), and distal ulnar fracture without involvement of physis (Fig. 1).
Simple radiographs A, A' At immediate postoperative. B, B' At 3 months later after injury, complete fracture union of distal ulna and partial physeal fusion of distal radius were observed. C, C' At 6 months later after injury, positive ulnar variance and complete physeal fusion of distal radius were observed. D, D' At 2 years later after injury, complete physeal closure of distal ulna and ulnar positive variance were observed.
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The complete distal ulnar physeal closure was observed at 2 years after the operation on radiographs, radial inclination was 21 , volar tilt was 17 , and ulnar variance was 7 mm (Fig. 2).
A, A' Posteroanterior (PA) and lateral radiographs of left wrist demonstrate positive ulnar variance and increased volar tilt. B, B' PA and lateral radiographs of right wrist.
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Radiographs presented decreased radial inclination and increased volar tilt and ulnar variance compared to the unaffected side (Fig. 3).
A, A' postoperative AP and lateral radiographs of left wrist. B, B' AP and lateral radiographs of left wrist at final 18 months follow-up.
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However, residual ulnar positive variance was observed following radial correction, and additional ulnar shortening osteotomy by 5 mm was performed (Fig. 4).
Clinical pictures at final follow-up demonstrate range of motion of both wrist.
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The fixatives was removed at 18 months after surgery (Table 1) (Fig. 5).