Roentgen stereophotogrammetric analysis of growth pattern after supination-adduction ankle injuries in children

J Pediatr Orthop. 1982 Aug;2(3):271-9. doi: 10.1097/01241398-198208000-00006.

Abstract

In a prospective study of supination-adduction (SA) ankle fractures in children, the post-traumatic growth pattern was registered with a roentgen stereophotogrammetric technique allowing exact determination of the growth rate within 3 months after fracture. It was possible to predict future growth pattern within 6 months. The SA injuries (10 cases) were divided into two stages according to Gerner-Smidt. One Stage I injury (physeal separation through the distal fibula) showed a growth stimulation. Nine Stage II injuries (including a fracture through the medial malleolus) showed four types of growth pattern besides symmetrical growth. The Salter-Harris classification alone showed no obvious correlation to the post-traumatic growth pattern, whereas factors such as age at injury, stage of injury, displacement, and treatment in combination with the Salter-Harris classification contributed to a better prediction of risk of deformity. It was found that displaced Stage II injuries in the younger child had the highest risk of developing a clinically significant varus deformity. Early determination of the post-traumatic growth pattern is of crucial importance in SA injuries with a high risk of growth deformities. Operative treatment in order to restore normal growth can be performed before a severe deformity has developed.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Ankle Injuries*
  • Ankle Joint / diagnostic imaging
  • Ankle Joint / growth & development
  • Child
  • Computers
  • Female
  • Fibula / diagnostic imaging
  • Fibula / growth & development
  • Fibula / injuries*
  • Fractures, Bone / diagnostic imaging
  • Fractures, Bone / physiopathology*
  • Humans
  • Male
  • Photogrammetry / methods*
  • Photography / methods*
  • Prospective Studies
  • Radiography
  • Tibia / growth & development
  • Tibial Fractures / diagnostic imaging
  • Tibial Fractures / physiopathology*