Subscribe to RSS
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.1055/s-0042-1748317
When to Suspect DRUJ's Instability in Children? Case Report of a Rare Presentation of Distal Forearm Fractures
![](https://www.thieme-connect.de/media/10.1055-s-00024358/202201/lookinside/thumbnails/10-1055-s-0042-1748317_210626cr-1.jpg)
Abstract
Pediatric displaced distal metaphyseal ulnar fractures and distal radial buckle fractures are common. However, to the best of our knowledge, their association has never been specifically reported. Thus, classification and management of this pattern remain challenging especially in young children. Distal radioulnar joint (DRUJ)'s assessment is difficult. A Galeazzi-equivalent injury should be suspected. We report the case of a 2-year-old boy who presented the above-mentioned association of forearm fractures and compare our management with actual recommendations. We would recommend a low-suspicion threshold for DRUJ's instability in young children presenting with displaced distal metaphyseal ulnar fracture associated with distal radial buckle fracture. That suspicion should raise the necessity of appropriate treatment and follow-up.
Publication History
Received: 15 September 2021
Accepted: 02 March 2022
Article published online:
09 June 2022
© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Schoenecker JG, Bae DS. Fracture of the distal radius and ulna. In: Flynn JM, Skaggs DL, Waters PM. eds. Rockwood & Wilkins' Fractures in Children. Eighth edition.. Philadelphia: Wolters Kluwer Health; 2015: 349-411
- 2 Joeris A, Lutz N, Blumenthal A, Slongo T, Audigé L. The AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF): Part I: Location and morphology of 2,292 upper extremity fractures in children and adolescents. Acta Orthop 2017; 88 (02) 123-128
- 3 Rodríguez-Merchán EC. Pediatric fractures of the forearm. Clin Orthop Relat Res 2005; 1 (432) 65-72
- 4 Pannu GS, Herman M. Distal radius-ulna fractures in children. Orthop Clin North Am 2015; 46 (02) 235-248
- 5 Little JT, Klionsky NB, Chaturvedi A, Soral A, Chaturvedi A. Pediatric distal forearm and wrist injury: an imaging review. Radiographics 2014; 34 (02) 472-490
- 6 Otayek S, Ramanoudjame M, Fitoussi F. [Distal radius fractures in children]. Hand Surg Rehabil 2016; 35S: S150-S155
- 7 Eberl R, Singer G, Schalamon J, Petnehazy T, Hoellwarth ME. Galeazzi lesions in children and adolescents: treatment and outcome. Clin Orthop Relat Res 2008; 466 (07) 1705-1709
- 8 Walsh HP, McLaren CA, Owen R. Galeazzi fractures in children. J Bone Joint Surg Br 1987; 69 (05) 730-733
- 9 Andersson JK, Lindau T, Karlsson J, Fridén J. Distal radio-ulnar joint instability in children and adolescents after wrist trauma. J Hand Surg Eur Vol 2014; 39 (06) 653-661
- 10 Letts M, Rowhani N. Galeazzi-equivalent injuries of the wrist in children. J Pediatr Orthop 1993; 13 (05) 561-566
- 11 Imatani J, Hashizume H, Nishida K, Morito Y, Inoue H. The Galeazzi-equivalent lesion in children revisited. J Hand Surg [Br] 1996; 21 (04) 455-457
- 12 Cha SM, Shin HD, Jeon JH. Long-term results of Galeazzi-equivalent injuries in adolescents–open reduction and internal fixation of the ulna. J Pediatr Orthop B 2016; 25 (02) 174-182
- 13 Schweisch P. Distal forearm fractures in children: Initial management - UpToDate [Internet]. Accessed April 1, 2022 at: https://www.uptodate.com/contents/distal-forearm-fractures-in-children-initial-management?search=distal%20forearm%20fracture&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
- 14 Williams KG, Smith G, Luhmann SJ, Mao J, Gunn III JD, Luhmann JD. A randomized controlled trial of cast versus splint for distal radial buckle fracture: an evaluation of satisfaction, convenience, and preference. Pediatr Emerg Care 2013; 29 (05) 555-559
- 15 Hennrikus WL, Mehlman CT. The community orthopedic surgeon taking trauma call: pediatric distal radius and ulna fracture pearls and pitfalls. J Orthop Trauma 2019; 33 (Suppl. 08) S6-S11