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Can J Surg. 2005 Apr;48(2):143-7.

Traumatic growth arrest of the distal tibia: a clinical and radiographic review.

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Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ont.



Injury to the physis of the distal tibia in children can lead to subsequent growth arrest. This can result in physeal bars, leg-length discrepancies and angular deformities.


The cases of 12 children with distal tibial growth arrest due to ankle trauma were reviewed. All were treated at a tertiary care institution between 1990 and 2002.


The average age at initial injury was 9.7 years (range 5-13 yr). Salter-Harris classifications (SH) of their injuries were SH2 in 4 children, SH3 in 1, SH4 in 6 and SH5 in 1 child. Four involved open fractures; 5 were high-energy injuries. Six of the injuries resulted in simple physeal bars, 4 caused pure angular deformities and 2 resulted in leg-length discrepancies > 2 cm. Eight of the physeal arrests were treated either with bar excision, selective epiphysiodesis or osteotomy for angular correction.


This series reinforces the importance of frequent follow-up of distal tibial physeal injuries in order to detect growth arrest early, thus facilitating corrective surgery.

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