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Surgical and Radiologic Anatomy

, Volume 33, Issue 8, pp 683–687 | Cite as

Anatomical landmarks in the paediatric distal radius: a new method for measuring epiphyseal height

  • Nima Heidari
  • Robert Eberl
  • Sebastian Wiklicky
  • Katrina Evers
  • Annelie M. Weinberg
Original Article

Abstract

Purpose

Elastic stable intramedullary nailing for fixation of paediatric forearm fractures has become the preferred method of osteosynthesis. The aim of the study was to develop a method for finding the correct entry point in the distal radius of children of all ages as a distance from the radial styloid, a landmark which is readily palpable at the wrist.

Method

MRI scans of the wrist in 19 children aged 2–7 years (mean 5) were reviewed. We noted that the proximal edges of the ossific nucleus of capitate and the tip of the radial styloid were at the same vertical height from the physis. This allowed us to review 519 wrist radiographs of children aged 2–14 years (mean 7.98) to measure the epiphyseal height, as the radial styloid does not ossify until the age of 14 years.

Results

The epiphyseal height had a mean of 16.67 mm (13–21 mm). The epiphyseal height in boys was greater than the girls by a mean of 1.2 mm (p < 0.0005).

Conclusion

For the absolute safe distance, we recommend an insertion site 40 mm proximal to the tip of the radial styloid, which is safe in all children with an open distal radial physis. This simple and reproducible method allows the identification of the insertion site for the nail with only the minimal use of imaging.

Keywords

Distal radius Distal radius epiphysis Forearm fractures Intramedullary nailing Elastic nailing forearm fractures Image intensifier 

Notes

Conflict of interest

The authors declare that they have no conflicts of interest.

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Nima Heidari
    • 1
  • Robert Eberl
    • 1
  • Sebastian Wiklicky
    • 1
  • Katrina Evers
    • 1
  • Annelie M. Weinberg
    • 1
  1. 1.Department of Paediatric and Adolescent SurgeryLandeskrankenhaus, Medical University GrazGrazAustria

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