title: [Growth behaviour after fractures of the proximal radius: differences to the rest of the skeleton].
abstract: BACKGROUND
  Fractures of the proximal end of the radius in the growth phase have three characteristics: the head of the radius articulates with two joint partners and is therefore indispensable for an undisturbed function of the elbow. The blood supply of the proximal end of the radius is via periosteal vessels in the sense of a terminal circulation which makes it extremely vulnerable. Severe trauma caused either by accidents or treatment, can result in partial or complete necrosis with deformity of the head and neck region of the radius.
  
  
  METHODS
  Radioulnar synostosis and chronic epiphysiolysis are irreversible complications which can occur after excessive physiotherapy. Despite a low potency growth plate, in young patients the proximal end of the radius shows an enormous spontaneous correction of dislocations. Side to side shifts, however, will not be remodeled.
  
  
  METHODS
  Therapy should be as atraumatic as possible. Due to the blood supply situation, with the appropriate indications the spontaneous correction and a brief period of immobilization without physiotherapy should be integrated into the therapy concept. If an operation is necessary, repeated traumatic repositioning maneuvers should be avoided and in case of doubt closed or careful open repositioning can be achieved with intramedullary nailing.
  
  
  CONCLUSIONS
  In order to take the special characteristics of the proximal radius into consideration, the vulnerability and correction potential must be weighed up against each other. Therapy must be as atraumatic as possible. The spontaneous correction potential should be integrated into the primary therapy without overestimating this potential with respect to the extent and age of the patient.
authors.affiliation: Kinderorthopädie, Operatives Kinderzentrum, Universitätsmedizin Göttingen, 37099, Göttingen, Deutschland, anna.hell@med.uni-goettingen.de.
authors.forename: A K
authors.initials: AK
authors.lastname: Hell
authors.forename: L
authors.initials: L
authors.lastname: von Laer
mesh_terms: D002648:Child; D003131:Combined Modality Therapy / Q000379:methods; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000601:surgery; D005593:Fracture Fixation, Internal / Q000379:methods; D017102:Fracture Healing; D006132:Growth Plate / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007103:Immobilization / Q000379:methods; D026741:Physical Therapy Modalities; D011859:Radiography; D011885:Radius Fractures / Q000175:diagnosis* / Q000628:therapy*; D020127:Recovery of Function; D000072042:Salter-Harris Fractures; D000092464:Elbow Injuries