Premature closure of the distal radial physis without evident history of trauma

The distal radius is the region of the body with the highest incidence of physeal injury. However, it is uncommon for the distal radius to undergo growth arrest without a history of trauma. We present a case of premature closure of the distal radial physis without evident history of trauma in a girl.A 14-year-old girl presented with chronic progressive deformity and painful functional limitation of her right forearm. The right wrist pain had begun when the patient was 5 years old. There was no evident history of trauma. The deformity and persistent right wrist pain had prevented her from performing sports activities and activities of daily living.Radiography and computed tomography showed a volarly angulated distal radius and dorsally protruding distal ulna with a length discrepancy between the distal radius and ulna due to premature physeal closure of the right distal radius.To eliminate the deformity and achieve painless functional recovery of the wrist, an opening wedge osteotomy of the distal radius with an iliac bone graft was performed, followed by a shortening osteotomy of the distal ulna.Radiography at final follow-up 1 year and 9 months postoperatively showed good alignment of the distal radioulnar joint without length discrepancy between the two forearm bones. The range of motion of the left wrist had reached 100% of the contralateral wrist without any pain, and the right grasp strength was 18 kg, which was 82% compared with the dominant left wrist.Premature closure of the distal radial physis impairs the growth potential of the physis and leads to wrist dysfunction due to deformities. In the present case, a satisfactory outcome was achieved via corrective osteotomy of the distal radius with an iliac bone graft combined with ulnar shortening osteotomy.