Correlation between fracture pattern and chronological age and skeletal maturity in distal radial fractures in children.

Abstract

Distal radius fractures are common injuries in children, accounting for 20-30 % of all childhood fractures. Although fracture location is thought to reflect skeletal maturity in children, the precise relationship between skeletal maturity and fracture location remains unclear. This retrospective observational study of 83 pediatric patients with distal radius fractures aimed to investigate the relationships between chronological age, skeletal maturity, fracture location, and fracture type. Patients were divided into two groups: those with physeal fractures (38 patients) and those with metaphyseal fractures (45 patients). Fracture types were classified as complete, greenstick, or torus. Skeletal maturity was assessed using a 9-point scale derived from the Tanner-Whitehouse method based on distal radius radiographs. Both chronological age and skeletal maturity were significantly higher in the physeal fracture group than in the metaphyseal fracture group. In addition, chronological age showed a slightly stronger association with fracture location than skeletal maturity. No significant association was found between age and fracture type. These results suggest that age-specific activity levels and injury mechanisms, in addition to skeletal maturity, may influence fracture location. Furthermore, greenstick and buckle fractures can occur even in older children with advanced skeletal maturity, highlighting the need for careful radiographic evaluation. These findings contribute to understanding the pathophysiology of pediatric fractures and may aid in fracture prevention and accurate diagnosis of radius fractures.