Physeal fractures of the distal tibia and fibula (Salter-Harris Type I, II, III, and IV fractures)

Journal of Pediatric Orthopedics
David A Podeszwa, Scott J Mubarak

Abstract

Physeal fractures of the distal tibia and fibula are common and can be seen at any age, although most are seen in the adolescent. An understanding of the unique anatomy of the skeletally immature ankle in relation to the mechanism of injury will help one understand the injury patterns seen in this population. A thorough clinical exam is critical to the diagnosis and treatment of these injuries and the avoidance of potentially catastrophic complications. Nondisplaced physeal fractures of the distal tibia and fibula can be safely treated nonoperatively. Displaced fractures should undergo a gentle reduction with appropriate anesthesia while multiple reduction attempts should be avoided. Gapping of the physis >3 mm after reduction should raise the suspicion of entrapped periosteum that will increase the risk of premature physeal closure. Open reduction of displaced Salter-Harris type III and IV fractures is critical to maintain joint congruity and minimize the risk of physeal arrest.

References

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May 23, 2009·Journal of Pediatric Orthopedics·Jeffrey T LearyJ Andrew Bowe

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Citations

Jul 23, 2013·Der Orthopäde·F J Schneider, W E Linhart
Oct 1, 2013·Clinics in Podiatric Medicine and Surgery·Paul DaytonNathan Coleman
Dec 9, 2014·Pediatric Annals·Mark E Halstead
Oct 12, 2016·Radiographics : a Review Publication of the Radiological Society of North America, Inc·M Cody O'DellSabah Servaes
Aug 22, 2014·Foot & Ankle Specialist·David A WoodJohn M Schuberth
Aug 24, 2017·Tissue Engineering. Part B, Reviews·Nichole ShawKarin A Payne
Aug 4, 2018·Journal of Pediatric Orthopedics·Dong Yeon LeeWhan Ik Jung
Jan 12, 2019·Journal of Orthopaedic Trauma·Allison BinkleyEllen Freeh
Apr 4, 2020·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Apeksha ChaturvediNina B Klionsky
Apr 3, 2013·The Journal of the American Academy of Orthopaedic Surgeons·Thomas H Wuerz, David P Gurd
Dec 6, 2016·SpringerPlus·Özgür Çiçekliİzzet Bingöl
Jun 20, 2020·Journal of Pediatric Orthopedics. Part B·Antti StenroosYrjänä Nietosvaara
May 10, 2021·Foot and Ankle Surgery : Official Journal of the European Society of Foot and Ankle Surgeons·Grégoire RougereauAlexandre Hardy

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