This is a plain-English translation of the academic paper above, prepared for patients, referring clinicians, and other non-specialist readers. It preserves the structure of the original paper while removing technical jargon. For the full clinical paper, follow the PubMed or DOI links.
Background
A simple, reproducible way of finding the safe entry point for a flexible metal rod when fixing a broken forearm bone in a child — a point that has to sit above the growth plate at the wrist, which cannot be damaged.
Rationale
In children, broken forearm bones are commonly fixed with flexible nails inserted near the wrist. If the entry point is too low, the surgeon risks damaging the growth plate, which can lead to a deformity that only becomes apparent as the child grows. Existing techniques rely on x-ray landmarks that are not always easy to use in young children.
Results
By comparing MRI scans (which show the growth plate directly) with x-rays (which do not, in young children), we found that a feature visible on x-ray — a particular small bone in the wrist — sits at the same height as the tip of a bony prominence the surgeon can feel through the skin. We measured 519 wrist x-rays in children aged 2 to 14 years. A simple rule of measuring 40 mm above that prominence gave a safe insertion point in every child with an open growth plate.
Implications
For a child with a forearm fracture being treated with flexible nails, this simple measurement helps surgeons avoid the growth plate — reducing both the risk of late deformity and the amount of x-ray exposure needed during surgery.
Source: Heidari N, Eberl R, Wiklicky S, Evers K, Weinberg AM. Anatomical landmarks in the paediatric distal radius: A new method for measuring epiphyseal height. Surgical and Radiologic Anatomy 2011;33(8):683-7. doi:10.1007/s00276-011-0797-7
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