Abstract
The aim of this study was to evaluate our treatment of distal tibial physeal injuries retrospectively and explain the relationship between the trauma mechanism, the radiographic injury pattern, the subsequent therapy and the functional outcome, as well as to further deduce and verify prognostic criteria. At the Department of Trauma Surgery, Vienna Medical University, 419 children and adolescent patients with physeal injuries of the distal tibia were treated from 1993 to 2007, of these 376 were included in our study and evaluated retrospectively. Seventy-seven displaced physeal fractures of the distal tibia were reconstructed anatomically by open or closed reduction and produced 95% excellent results. A perfect anatomical reduction, if necessary by open means, should be achieved to prevent a bone bridge with subsequent epiphysiodesis and post-traumatic deformities due to growth inhibition and/or retardation.
Similar content being viewed by others
References
Peterson CA, Peterson HA (1972) Analysis of the incidence of injuries to the epiphyseal growth plate. J Trauma 12:275–281
Rathjen K, Birch J (2006) Physeal injuries and growth disturbances. In: Rockwood and Wilkins fractures in children, 6th edn. Lippincott Williams & Wilkins, Philadelphia, pp 102–104
De Sanctis N, Della Corte S, Pempinello C (2000) Distal tibial and fibular epiphyseal fractures in children: Prognostic criteria and long term results in 158 patients. J Pediatr Orthop Part B 9:40–44
Melchior B, Badelon P, Peraldi P, Bensahel H (1990) Les fractures decollementes epiphysaires de l’extremite inferieure du tibia. Chir Pediatr 31:113–118
Carothers CO, Crenshaw AH (1953) Clinical significance of a classification of epiphyseal injuries of the ankle. Am J Surg 89:879–889
Aitken AP (1936) The end results of the fractured distal tibial epiphysis. J Bone Joint Surg 18:685–691
Salter RB, Harris WR (1963) Injuries involving the epiphyseal plate. J Bone Joint Surg Am 45:587–622
Hajdu S, Kaltenecker G, Schwendenwein E, Vécsei V (2000) Apophyseal injuries of the proximal tibial tubercle. Int Orthop 24:279–281
Berson L, Davidson RS, Dormans JP, Drummond DS, Gregg JR (2000) Growth disturbance after distal physeal fractures. Foot Ankle Int 21:54–58
Williamson RV, Staehli LT (1990) Partial physeal growth arrest: treatment by bridge resection and fat interposition. J Pediatr Orthop 10:769–776
Ashhurst APC, Bromer RS (1922) Classification and mechanism of fractures of the leg bones involving the ankle. Arch Surg 4:51–129
Sferopoulos NK (2007) Type V physeal injury. J Trauma 63:121–123
Kling TF, Bright RW, Hensinger RN (1984) Distal tibial physeal fractures in children that might require an open reduction. J Bone Joint Surg Am 66:647–657
Lalandle K, Letts M (2005) Traumatic growth arrest of the distal tibia: a clinical and radiographic review. Can J Surg 2:143–147
Sailhan F, Chotel F, Guibal AL, Gollogly S, Adam P, Bérard J, Guibaud L (2004) Three dimensional MR imaging in the assessment of physeal growth arrest. Eur Radiol 14:1600–1608
Cottalorda J, Béranger V, Louahem D, Camilleri JP, Launay F, Diméglio A, Bourelle S, Jouve JL, Bollini G (2008) Salter-Harris type III and IV medial malleolar fractures: growth arrest is it a fate? J Pediatr Orthop 28:652–655
Spiegel P, Cooperman D, Laros G (1978) Epiphyseal fractures of the distal ends of the tibia and fibula. J Bone Joint Surg Am 60:1046–1059
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Schurz, M., Binder, H., Platzer, P. et al. Physeal injuries of the distal tibia: long-term results in 376 patients. International Orthopaedics (SICOT) 34, 547–552 (2010). https://doi.org/10.1007/s00264-009-0851-9
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00264-009-0851-9