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J Pediatr Orthop. 2006 May-Jun;26(3):322-8.

Salter-Harris I and II fractures of the distal tibia: does mechanism of injury relate to premature physeal closure?

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1
Children's Hospital and Health Center, San Diego, CA 92123, USA.

Abstract

INTRODUCTION:

The distal tibial physis is the second most commonly injured physis in long bones. Recent reports demonstrate a high rate of premature physeal closure (PPC) in Salter-Harris (SH) type I or II fractures of the distal tibia.

METHODS:

At our institution, 137 distal tibial SH type I or II fractures were treated from 1994 to 2002. Reviews were performed on all patients and 91 fractures met inclusion criteria. Patients were categorized according to treatment.

RESULTS:

We report a PPC rate of 39.6% in SH type I or II fractures of the distal tibial physis. We found a difference in PPC based on injury mechanism. The rate of PPC in patients with a supination-external-rotation-type injury was 35%, whereas patients with pronation-abduction-type injuries developed PPC in 54% of cases. Type of treatment may prevent PPC in some fractures. The most important determinant of PPC is the fracture displacement following reduction.

DISCUSSION AND CONCLUSION:

PPC is a common problem following SH type I or II fractures of the distal tibia. Operative treatment may decrease the frequency of PPC in some fractures. Regardless of treatment method, we recommend anatomic reduction to decrease the risk of PPC.

[Indexed for MEDLINE]

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