II. Mechanism

  1. Epiphyseal Plate is weaker than nearby wrist ligaments

III. Signs

  1. Fracture through distal radial epiphysis
  2. Tenderness to palpation over the radial epiphysis
    1. Highly suggestive of Fracture

IV. Radiology: Wrist XRay

  1. Difficult to identify non-displaced Fracture
  2. Think Epiphyseal Fracture in children
    1. Wrist Sprains in children are rare

V. Management

  1. Displaced Radial Epiphyseal Fracture
    1. Reduce as with Colles Fracture
    2. Immobilize for 5 weeks
  2. High suspicion for Fracture without radiologic evidence
    1. Immobilize in Short Arm Cast or splint for 2 weeks
    2. Repeat Wrist XRay
    3. Cast for 2 more weeks if callus present on XRay

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