11 years post-surgical outcome for an isolated distal ulnar Salter-Harris IV fracture with distal radioulnar joint disruption – A case report and literature review

Abstract

Background: Intraarticular fractures of the distal ulna rarely occur as an isolated phenomenon. We describe one such case with distal radioulnar joint disruption in a 13-year-old child who sustained an injury to his dominant right wrist following a fall on an outstretched hand. Case report: Radiographic findings showed a displaced distal ulnar Salter-Harris IV fracture with dorsal dislocation of the ulna head. The fracture was reduced and internally fixed using K-wires to minimise physeal damage. Physeal arrest led to a negative ulnar variance and increased radial bow. Nevertheless, results were excellent and our patient returned to pre-injury functioning levels within two months which was maintained at 11 years. Isolated distal ulnar physeal injuries are indeed rare. When they do occur, we prefer open reduction and pinning to minimise further injury. The risk of premature physeal arrest is high together with its related complications. Nevertheless, functional outcome is generally positive.