Physeal injury of distal tibia in children – epidemiological study

Czech version

Authors: Ladislav Plánka; Vladimír Bartl; Jan Škvařil; Jiří Jochymek; Petr Gál
Authors‘ workplace: Clinic of paediatric surgery, orthopaedics and traumatology, University hospital Brno ; Klinika dětské chirurgie, ortopedie a traumatologie Fakultní nemocnice Brno
Published in: Úraz chir. 17., 2009, č.1

Overview

AIM:
Distal tibial fractures represent 25–35 % of all fractures in children; they are the second most frequented fractures after the distal radial fractures. Approximately 4 % of them damaged the distal tibial growth plate. The aim of this study was to analyse all patients with distal tibial epiphyseal fractures and results of their treatment in Clinic of paediatric surgery, orthopaedics and traumatology in last 11 years.

METHODS:
207 children aged 0–19 were completely treated in Clinic of paediatric surgery, orthopaedics and traumatology with distal tibial epiphyseal fractures from 1. 1. 1997 to 31. 12.2007. The X-ray images from injury to completely consolidation were controlled, the treatment, clinical results and occurrence of complications too. The successful result of healing was without angulation (less than 5 °), shortening (less than 1 cm) and the other complications.

RESULTS:
In sum, 141 (68,3 %) patients were treated conservatively and 66 (31,8 %) patients were treated under general anaesthesia. In whole patient group no clinical disorders were recorded (pain or mobility of the ankle after injury). In eight cases the angulation of distal tibia more than 5 ° after therapy was noted. The second most common complication was redisplacement after closed reduction (7 patients), solely by SH II (17 % of all displaced SH II). In five cases the repeated reduction and in two cases the osteosynthesis were the final resolution.

CONLUSION:
This watched diagnostic – therapeutical process results in 93% excellent clinical outcomes. Complication incidence rate of this process is a little lower compared to foreign studies. So, this diagnostic – therapeutic process can be used as diagnostic – therapeutic standard for this type of physeal injury in children.

KEY WORDS:
tibia, growth plate, childhood, epiphyseolysis.

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Article was published in

Trauma Surgery

2009 Issue 1