Premature closure of the distal ulnar physis: valgus and radius curvus
5-month-old German Shepherd that suffered trauma to the left forelimb 6 weeks ago. It now has carpal valgus, external rotation of the paw and cranial bowing of the radius. Radiographs show closure of the distal ulnar physis with the distal radial physis still open and early elbow incongruity.
What is the most appropriate management at this stage?
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A. Wait until growth ends and then correct everything in a single surgery
While the radius keeps growing and the ulna does not, the deformity and elbow incongruity worsen every week, and the elbow damage may become irreversible.
B. Segmental ostectomy of the distal ulna to release the radius, and consider a corrective radial osteotomy when growth is complete
Correct. Removing a segment of ulna (often with a fat graft to prevent it from bridging again) eliminates the 'bowstring' that bends the radius and decompresses the elbow, taking advantage of the remaining growth. Residual deformity is corrected later.
C. Rigid splint during growth to straighten the radius
A splint cannot counteract the growth force of the physis and also causes stiffness and pressure sores. It does not correct angular deformities.
D. Immediate corrective radial osteotomy without addressing the ulna
If the ulna is not released, the radius will continue growing against it and the deformity will recur; moreover, the elbow incongruity is not resolved.
lightbulb Key takeaway
The distal ulnar physis provides most of the ulna's longitudinal growth and, because of its conical shape, is the most prone to compression injuries (Salter-Harris type V), which are not visible on initial radiographs: recheck puppies 2–4 weeks after forearm trauma. In adults, correction is planned by locating the centre of rotation of angulation (CORA) and comparing with the healthy limb.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.