All-inside physeal bar resection for partial physeal arrest of the distal radius with the aid of an arthroscope and patient-specific instrument.

Abstract

Purpose: The premature closure of the epiphysis of the distal radius is an infrequent condition in pediatric patients, often resulting in distal radius deformity. Currently, there is limited literature on its treatment, and controversy exists. This study aimed to evaluate the clinical efficacy of all-inside physeal bar resection with the aid of an arthroscope and patient-specific instrument.

Methods: We retrospectively reviewed the patients who sustained distal radius physeal bar resection under all-inside visualization of the arthroscope with the aid of a patient-specific instrument during 2016-2022. Follow-up was performed for a minimum of 2 years, during which pre-operative and post-operative clinical and radiological parameters were compared.

Results: There were six boys and two girls enrolled in this study. Six patients got satisfied results, while two patients didn't benefit from the surgery. The mean pre-operative RAA of the affected side was -11.4° ± 13°, while the post-operative radial articular angle was 3.4° ± 11°. There was a significant difference between them. The mean pre-operative ulnar variance was 7.6 mm ± 6 mm, while the post-operative UV was 3.3 cm ± 8 mm. There was no significant difference between them. The pre-operative modified Mayo Wrist Score was 92 ± 5, while that for post-operative was 96 ± 7.

Conclusion: All-inside physeal bar resection for partial physeal arrest of the distal radius with the aid of an arthroscopy and patient-specific instrument is minimally invasive, accurate, and safe. It should be the one option treatment for the premature closure of the distal radius epiphysis.