Orthopedics - Oleksa A.P. 2006

Osteochondropathies
Osteochondropathy of the distal epiphysis of the radius or ulna

Osteochondropathy of the distal radial epiphysis was first described by de Cuveland, and that of the ulna by Bruns (1931). The condition has an insidious onset and a protracted course, initially manifesting as pain in the radioulnar and wrist joints following physical overload of the upper extremity during athletic activities or manual labor.

On physical examination, apart from mild localized Swelling, no other pathological changes are detected. Palpation does not exacerbate the localized tenderness, which is, however, accentuated during rotational Movements of the forearm.

Radiological findings include mottling of the epiphyseal bone, blurring of the trabecular architecture, and irregularity with serrated margins of the ossification centers.

Treatment. To eliminate pronation and supination of the forearm, a dorsal plaster splint is applied from the middle third of the arm to the metacarpal heads, with the hand maintained in a functionally advantageous position. Lightweight plastic orthoses are now commonly used instead of traditional plaster splints. Patients are prescribed thermal modalities and physical therapy combined with balneotherapy, during which the orthosis is temporarily removed. Once pain subsides completely, immobilization of the limb is no longer necessary; however, strenuous physical activity, particularly involving the wrist joint, remains strictly contraindicated.