Presentation
Blunt trauma: the patient fell and injured his wrist during a sporting activity.
Patient Data
There is a complete slip of the right radial epiphysis, dorsolaterally with foreshortening and regional soft tissue swelling. There is a curvilinear bone fragment representing a fracture through the radial metaphysis.
There is a longitudinal fracture through the ulna epiphysis with minimal medial physeal widening and regional soft tissue swelling.
There is a left scaphoid accessory ossicle (os radiale externum). There is a symmetric
right os radiale externum best visualized on the lateral series.
There are two perpendicular Kirschner wires (K-wires) fixating the right distal radius with improved alignment and satisfactory reduction post-surgical intervention.
There is a plaster cast in situ.
Case Discussion
An example of a Salter-Harris type II physeal injury of the distal right radius.
The ulna findings likely represent an avulsion fracture injury of the ulna epiphysis (more common) rather than a type III ulna Salter Harris injury (uncommon).
There are incidental accessory scaphoid ossicles rather than scaphoid fractures 1.
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