Complete radial metaphyseal fractures tend to occur in children above 5 years of age.
The periosteum is either partially or totally disrupted and will influence the choice of treatment. In case of minor posterior angulation, the posterior periosteum will be intact, whereas the anterior periosteum will be torn. The degree of angulation and the bone age of the child determine the tolerance for accepting residual malalignment.
If reduction fails to achieve an acceptable position operative treatment may be indicated. In the first instance this is likely to be closed reduction under general anesthesia and percutaneous fixation with K-wires.
Open reduction might be necessary if the periosteum, or quadratus muscle, is interposed preventing a successful closed reduction.