Clinical and radiological results in distal tibial physeal injuries

Abstract

Background In this study, we evaluated the clinical and radiological results of the distal tibial epiphyseal fractures in children treated with surgery. Methods We evaluated 59 patients (33 boys, 26 girls) retrospectively. Physeal fractures were classified according to the Salter- Harris classification: 4 fractures were type I, 22 type II, 29 type III, and the remaining 4 type IV. Closed reduction and internal fixation were performed in 29 patients, while open reduction and internal fixation were performed in 30 patients. Mean age at the time of trauma was 10.9 years (6-14). Patients were evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) score. Results Patients were operated in a mean of 3.8 hours (3-72). Fixation was performed with Kirschner (K)-wire in 50 patients, with screw in 6 patients, and with both K-wire and screw in 3 patients. Mean follow-up time was 71.7 months (12- 149). Due to premature physeal arrest, 1 cm shortening and valgus deformity were seen in only one patient. However, no infection, nonunion, or osteonecrosis was observed in any patient. Mean AOFAS score was 86.6 (65-100) at the last follow-up. Conclusion Successful results with fewer complications could be obtained in ankle physeal fractures with early management through adequate reduction and stabilized fixation.