Traitement des fractures décollements épiphysaires du radius distal chez l’enfant

Objective: To assess the results of treatment of epiphyseal injuries of the distal radius. Material and methods: Retrospective study of 53 patients treated in the pediatric surgery department on children between 2002 and 2012 for a distal radius epiphyseal fracture. The mean age of 12.5 years. According to Salter-Harris classification, fractures were classified of type I in 35 patients (66%) and types II 18 (34%) cases. The average treatment time was 1.42 days. In primary intention, closed reduction followed by cast immobilization was achieved in patients. Failure of closed reduction imposed of open reduction followed by pin fixation. Post-care results were evaluated on the functional and morphological study of the upper limb. Results: Post-operative complications occurred in seven patients. Failures of closed reduction were caused by irreducibility due to periosteum interposition in 5 patients with type II fractures and by a redisplacement in 2 patients with type I fracture. In these patients, treatment consisted of a fixation pin by open pit. The good results occurred in 49 (92.5%) and sequelae occurred in four (7.5%) patients. Sequelae were represented by a stiff wrist in 3 cases (5.6%), limitation of pronation supination in 1 case (1.8%). Conclusion: The results of treatment of epiphyseal injuries of the distal radius in children are accompanied by a low rate of complications. But prolonged follow up is required because growth disturbances predominated among the complications. Key-words: epiphyseal injuries, child, distal radius