Clinical and radiological results in distal tibial physeal injuries

Background: In this study, we evaluated the clinical and radiological results of the distal tibial epiphyseal fractures in children treated with surgery.
Methods: We evaluated 59 patients (33 boys and 26 girls) retrospectively. Physeal fractures were classified according to the Salter-Harris classification; 4 fractures were in type I, 22 were in type II, 29 were in type III and remaining 4 fractures were in type IV. Closed reduction and internal fixation was performed in 29 patients while open reduction and internal fixation were performed in 30 patients. Mean age at the time of trauma was 10.9 years (6-14). Patients were evaluated by AOFAS score.
Results: Patients were operated in mean 3.8 hours time (3-72). Fixation was performed with K-wire in 50 patients, with screw in 6 patients, and with both K-wire and screw in 3 patients. Mean follow-up time was 71.7 months (12-149). Complications like premature physeal arrest, limb length inequality, angular deformity, infection, nonunion, and osteonecroses were not observed in any patients. Mean AOFAS score was 86.6 (65-100) at last follow-up.
Conclusion: Successful results with fewer complications could be obtained in ankle ephyseal fractures by early management through adequate reduction and stabilized fixation using maximum two reduction maneuvers.

Tibia alt uç büyüme plaðý yaralanmalarýnda klinik ve radyolojik sonuçlar

Amaç: Bu çalýþmada tibia alt uç büyüme plaðý yaralanmasý sebebiyle cerrahi tedavi edilen çocuklarda yaralanmanýn daðýlýmý incelenerek klinik ve radyolojik sonuçlar deðerlendirilmiþtir.
Gereç ve yöntem: 26’sý kýz, 33’ü erkek olan toplam 59 olgu retrospektif olarak deðerlendirildi. Büyüme plaðý kýrýklarý Salter-Harris’ sýnýflamasýna göre sýnýflandýrýldý; kýrýklarýn 4’ü tip I, 22’si tip II, 29’u tip III ve 4’ü tip IV idi. 29 hastaya kapalý, 30 hastaya açýk redüksiyon ve internal tespit uygulandý. Kýrýk anýnda ortalama hasta yaþý 10,9 (6-14) idi. Hastalar AOFAS sistemine göre deðerlendirildi.
Bulgular: Hastalar ortalama 3,8 saat (3-72) içinde ameliyata alýndý. Tespitte 50 hastada yalnýzca K teli, 6 hastada sadece vida, 3 hastada da K teli ve vida birlikte kullanýldý. Ýzlem süresi ortalama 71,7 ay (12-149) idi. Hiçbir hastada erken fizis kapanmasý, ekstremite kýsalýðý, açýsal deformite oluþumu, enfeksiyon, kaynamama, osteonekroz gibi komplikasyonlar ile karþýlaþýlmadý. Son kontrollerinde AOFAS skoru ortalama 86,6 (65-100) olarak saptandý.
Sonuç: Ayak bileði epifiz kýrýklarýnda, erken müdahale ile en fazla iki kez redüksiyon manevrasý kullanýlarak yeterli redüksiyon ve stabil tespit saðlanmasý halinde baþarýlý sonuçlar elde edilebilir ve komplikasyonlar en aza indirilebilir.