What is the treatment for a Salter II radius fracture?

From the Guidelines

The treatment for a Salter II radius fracture typically involves closed reduction followed by immobilization in a cast for 4-6 weeks. The management of this type of fracture prioritizes minimizing morbidity, mortality, and optimizing quality of life by promoting proper bone healing and reducing the risk of complications. When considering the treatment approach, it is essential to evaluate the degree of displacement and angulation of the fracture. For minimally displaced fractures with less than 10-15 degrees of angulation, immobilization alone may be sufficient, as noted in studies discussing the treatment of similar fractures 1. Key aspects of the treatment include:

• Closed reduction under local or general anesthesia to manually realign the fracture
• Immobilization in a long-arm cast for the initial 3-4 weeks, followed by a short-arm cast for the remaining period
• Regular follow-up radiographs at 1,2, and 4 weeks to ensure the fracture remains properly aligned during healing
• Physical therapy after cast removal to restore strength and range of motion The goal of this treatment approach is to leverage the good healing potential of Salter-Harris type II fractures, which is facilitated by the intact periosteum on one side of the growth plate, providing stability and blood supply for bone healing while minimizing the risk of growth disturbance. In cases where the fracture is severely displaced or unstable, surgical intervention with Kirschner wire fixation may be necessary to maintain proper alignment and ensure optimal healing outcomes. By prioritizing evidence-based treatment strategies, clinicians can effectively manage Salter II radius fractures, reducing the risk of long-term consequences such as growth disturbances, deformities, or chronic pain, and ultimately improving patient quality of life.

From the Research

Treatment for Salter II Radius Fracture

• The treatment for a Salter II radius fracture typically involves orthopedic reduction in the emergency room or operating room, under general anesthesia, followed by plaster immobilization 2.
• The goal of treatment is to achieve proper alignment of the fracture and prevent malunion or growth disturbances.
• In some cases, surgical intervention may be necessary to rectify the position of the radial joint surface, especially if there is significant displacement or angulation of the fracture 2.

Long-Term Consequences

• Neglected or incorrectly treated Salter II radius fractures can lead to malunion, radiocarpal subluxations, and growth disturbances 2.
• Premature physeal closure is a potential complication of Salter II fractures, which can result in growth arrest and deformity 3, 4.
• The risk of premature physeal closure is higher in patients with greater initial displacement or high-grade injury mechanisms 4.

Management

• Closed reduction and immobilization in a plaster device is often the initial treatment for Salter II radius fractures 2, 5.
• Intrafocal K-wire pinning is a surgical technique that can be used to treat Salter II distal radial fractures, which minimizes the risk of physeal damage 6.
• The choice of treatment depends on the severity of the fracture, the age and condition of the patient, and the presence of any complications or associated injuries.
• Regular follow-up and monitoring are essential to ensure proper healing and to detect any potential complications early on 2, 3, 5, 4, 6.