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Nonunion in a distal radius metaphyseal fracture in a child

Role of intact periosteal sleeve in management

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Abstract

We present an adolescent with distal radius nonunion following an open fracture and failed surgery which eventually united when the length andstability was restored for eight weeks duration. The intact periosteal sleeve at the nonunion site formed new bone when its tension was restored by gradual differential distraction. This case report highlights the possibility ofstimulating bony union in an established atrophic nonunion by distracting the minimally disturbed soft tissue and thick osteogenic periosteal envelope in the paediatric age group.

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References

  1. Shrader MW, Stans AA, Shaughnessy WJ, Haidukewych GJ. Nonunion of fractures in pediatric patients: 15-year experience at a level I trauma center. Orthopedics 2009;32:410.

    Article  Google Scholar 

  2. Rang M, Wenger DR. Children are not just small adults. In: Wenger DR, Pring ME, Rang M, editors. Rang’s Children’s Fractures. Philadelphia: Lippincott Williams and Wilkins; 2005. p. 8.

    Google Scholar 

  3. McKee MD, Waddell JP, Yoo D, Richards RR. Nonunion of distal radial fractures associated with distal ulnar shaft fractures: A report of four cases. J Orthop Trauma 1997;11:49–53.

    Article  CAS  Google Scholar 

  4. Kwa S, Tonkin MA. Nonunion of a distal radial fracture in a healthy child. J Hand Surg Br 1997;22:175–7.

    Article  CAS  Google Scholar 

  5. Song KS, Kim HK. Nonunion as a complication of an open reduction of a distal radial fracture in a healthy child: A case report. J Orthop Trauma 2003;17:231–3.

    Article  Google Scholar 

  6. Sabharwal S. Treatment of traumatic radial clubhand deformity with bone loss using the Ilizarov apparatus. Clin Orthop Relat Res 2004;424:143–8.

    Article  Google Scholar 

  7. Waters P, Bae DS. Fractures of distal radius and ulna. In: Beaty JH, Kasser JR, editors. Rockwood and Wilkins Fractures in Children. Philadelphia: Lippincott Williams and Wilkins; 2009. p. 335.

    Google Scholar 

  8. Fernandez FF, Eberhardt O, Langendörfer M, Wirth T. Nonunion of forearm shaft fractures in children after intramedullary nailing. J Pediatr Orthop B 2009;18:289–95.

    Article  Google Scholar 

  9. Théorêt C, Stanciu C. Post - traumatic nonunion of the ulna in a child. Can J Surg 2001;44:301–3.

    PubMed  PubMed Central  Google Scholar 

  10. Kocaoglu M, Eralp L, Sen C, Cakmak M, Dincyürek H, Göksan SB. Management of stiff hypertrophic nonunions by distraction osteogenesis: A report of 16 cases. J Orthop Trauma 2003;17:543–8.

    Article  Google Scholar 

  11. Tomic S, Bumbasirevic M, Lesic A, Mitkovic M, Atkinson HD. Ilizarov frame fixation without bone graft for atrophic humeral shaft nonunion: 28 patients with a minimum 2-year follow-up. J Orthop Trauma 2007;21:549–56.

    Article  Google Scholar 

  12. Wilde GP, Baker GC. Circumferential periosteal release in the treatment of children with leg-length inequality. J Bone Joint Surg Br 1987;69:817–21.

    Article  CAS  Google Scholar 

  13. Warrell E, Taylor JF. The role of periosteal tension in the growth of long bones. J Anat 1979;128:179–84.

    PubMed  PubMed Central  CAS  Google Scholar 

  14. Xin ZF, Kim KH, Jung ST. Regeneration of the fibula using a periosteum-preserving technique in children. Orthopedics 2009;32:820.

    PubMed  Google Scholar 

  15. Dodabassappa SN, Shah HH, Joseph B. Donor site morbidity following the harvesting of cortical bone graft from the tibia in children. J Child Orthop 2010;4:417–21.

    Article  Google Scholar 

  16. Hinsche AF, Giannoudis PV, Matthews SE, Smith RM. Spontaneous healing of large femoral cortical bone defects: Does genetic predisposition play a role? Acta Orthop Belg 2003;69:441–6.

    PubMed  Google Scholar 

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Correspondence to Balasubramanian Balakumar.

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Sivashanmugam, R., Vijay, S. & Balakumar, B. Nonunion in a distal radius metaphyseal fracture in a child. IJOO 49, 109–113 (2015). https://doi.org/10.4103/0019-5413.143919

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  • DOI: https://doi.org/10.4103/0019-5413.143919

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