Salter-Harris Type III and IV medial malleolar fractures: growth arrest: is it a fate? A retrospective study of 48 cases with open reduction

Journal of Pediatric Orthopedics
J CottalordaGérard Bollini

Abstract

Salter-Harris type III and IV medial malleolar fractures (MacFarland fracture) is a joint fracture of the ankle in children. The fracture line passes through the medial part of the lower epiphyseal disk of the tibia. Prognosis is dominated by later risk of misalignment and osteoarthritis. The aim of this study was to evaluate the functional and radiological outcome of these fractures. We retrospectively analyzed the cases of 48 children with MacFarland fractures (31 boys and 17 girls), mean age at the time of trauma 11 years 6 months (range, 8-15 years). The fractures were classed into two groups according to the Salter and Harris classification for epiphyseal detachment: Salter III (30 cases) and Salter IV (18 cases). Surgical treatment was given in all cases (46 screw fixations, 2 pin fixations). Three outcome categories were used: good (no pain, no stiffness, no limp, no misalignment, no surgical complication, no healing problem), fair (pain and/or stiffness and/or limp and/or healing problem without misalignment, no surgical complication), and poor (misalignment or surgical complication). Mean follow-up was 3 years and 3 months (24-94 months). Twenty-eight children were skeletally mature at the longest follow-up. The three-...Continue Reading

References

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Citations

Jan 12, 2013·Der Orthopäde·S RammeltH Zwipp
Jul 16, 2013·Skeletal Radiology·Panagiotis D SymeonidisPanagiotis G Givisis
Aug 8, 2009·International Orthopaedics·Mark SchurzVilmos Vécsei
Jun 22, 2010·Archives of Orthopaedic and Trauma Surgery·Stefan P LemburgChristoph M Heyer
Sep 23, 2011·Veterinary and Comparative Orthopaedics and Traumatology : V.C.O.T·G M HayesS J Langley-Hobbs
Aug 19, 2016·Wiener klinische Wochenschrift·Thomas M TiefenboeckMark Schurz
Apr 2, 2016·The Cochrane Database of Systematic Reviews·Denise E YeungSimon L Barker
Jun 30, 2018·Journal of Pediatric Orthopedics. Part B·William ZelentyDavid H Godfried
Jan 12, 2019·Journal of Orthopaedic Trauma·Allison BinkleyEllen Freeh
Sep 19, 2020·Journal of Orthopaedic Surgery and Research·Quanwen YuanYunfang Zhen
Aug 14, 2020·Der Unfallchirurg·Dorien SchneidmuellerDirk Sommerfeldt
Jan 11, 2021·Seminars in Roentgenology·Jessica R Leschied, Steven B Soliman
Nov 10, 2020·Journal of Pediatric Orthopedics. Part B·Neeraj MishraArjandas Mahadev

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