Retrospective Study Of Open Surgery On Old Epiphyseal Plate Fractures Of The Distal Radius In Children

Purpose: Closed reduction and cast immobilization was recommended for epiphyseal plate fractures of the distal radius in children.However,it has a high rate of re-displacement,and closed reduction is not allowed.At present,there are still disputes about the need for conservative treatment or open surgery for this kind of old fractures,and there is no expert consensus or guidelines.The purpose of this study was to evaluate the effect of surgical treatment of such fractures,to clarify the feasibility of surgical treatment,and to analyze the prognostic factors.Methods: In this retrospective study,we included 25 patients(22 male,3 female)who underwent open surgery for old epiphyseal plate fractures of the distal radius.The outcomes of wrist function were evaluated by the Cooney score,and the predictors included type of residence,age,gender,fracture type,days after injury(DAI),degree of violence(DOV),and angulation of fracture before surgery(AFBS).Results: on the whole,16 cases(64%)had excellent wrist function,6cases(24%)were good,and 3 cases(12%)were average.The rate of excellent wrist function in children over 9 years old was 85.7%(12 / 15),and that in children under 9 years old was only 40.0%(4 / 10)(P = 0.024).Cooney wrist function score was positively correlated with age,but not correlated with residence type,gender,fracture type,DAI,DOV and AFBS.Conclusion: Open reduction surgery is a feasible treatment for old epiphyseal fractures of the distal radius in patients aged over 9 years.