Displaced Salter-Harris I fracture of the distal ulna physis

• Published in: BMJ case reports Vol. 12; no. 8; p. e230783
• Main Authors: Clesham, Kevin, Piggott, Robert P, Sheehan, Eoin
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.08.2019; BMJ Publishing Group
• Series: Case Report
• Subjects: Athletic Injuries - diagnostic imaging; Athletic Injuries - surgery; Calcification; Case reports; Child; Closed Fracture Reduction; Epidemiology; Female; Fractures; Humans; Injuries; Patients; Pediatrics; Population; Radiography; Radius Fractures - diagnostic imaging; Radius Fractures - surgery; Salter-Harris Fractures - diagnostic imaging; Salter-Harris Fractures - surgery; Trauma; Treatment Outcome; Ulna Fractures - diagnostic imaging; Ulna Fractures - surgery; Unusual Presentation of More Common Disease/Injury; Writing; paediatrics; orthopaedics; orthopaedic and trauma surgery; radiology
• DOI: 10.1136/bcr-2019-230783
• ISSN: 1757-790X

A 10-year-old girl presented to the emergency department having sustained a fall onto an outstretched left hand while playing soccer. Clinical and radiographical assessment identified a Salter-Harris I distal ulna fracture, as well as a buckle fracture of the distal radius. The injury was closed, and she had no neurovascular deficits on examination. She was brought to the operating theatre the following morning for closed reduction under general anaesthesia. Image intensification was used to confirm anatomical reduction, and an above-elbow moulded plaster-of-paris cast was applied. Follow-up clinical assessment at 6 weeks confirmed healing of the fracture, and she proceeded to make a full recovery. This case describes the anatomy and physiology of such rare injuries and outlines treatment principles and potential pitfalls based on best available evidence.