Traumatic injuries of the thoracic and lumbar spine are rare in children and differ in pathomorphology, healing process and prognosis from those in adults. Before growth arrest the vertebral epiphysis has an important role in pathomorphology and prognosis; therefore, treatment should recognize the age-dependent potential for growth and remodelling. This study demonstrates the different anatomic and pathomorphologic characteristics of traumatic spinal injuries in 40 children. Additionally, prognosis and the various forms of treatment are discussed in the context of the recent literature. In total we observed 85 % compression-type injuries and 15 % distraction- and rotation-type injuries. Vertebral body fractures were treated conservatively and segmental disruptions by fusion. Long-term follow-up was performed on average 8 years after the accident in 26 patients clinically and in 21 patients radiologically. Most patients had no physical complaints or clinical symptoms. Additionally, the radiographs did not demonstrate any post-traumatic defects. In summary, spinal injuries up to the age of 12 without initial neurologic symptoms have a favorable prognosis.

Traumatic injuries of the thoracic and lumbar spine are rare in children and differ in pathomorphology, healing process and prognosis from those in adults. Before growth arrest the vertebral epiphysis has an important role in pathomorphology and prognosis; therefore, treatment should recognize the age-dependent potential for growth and remodelling. This study demonstrates the different anatomic and pathomorphologic characteristics of traumatic spinal injuries in 40 children. Additionally, prognosis and the various forms of treatment are discussed in the context of the recent literature. In total we observed 85% compression-type injuries and 15% distraction- and rotation-type injuries. Vertebral body fractures were treated conservatively and segmental disruptions by fusion. Long-term follow-up was performed on average 8 years after the accident in 26 patients clinically and in 21 patients radiologically. Most patients had no physical complaints or clinical symptoms. Additionally, the radiographs did not demonstrate any post-traumatic defects. In summary, spinal injuries up to the age of 12 without initial neurologic symptoms have a favorable prognosis.

Development of an angular deformity around the knee joint, following a posttraumatic premature epiphyseal closure is a rare but serious complication. We present a case report of this complication following a proximal tibial epiphyseal injury in a 9 year old child initially treated conservatively with plaster immobilization. Subsequently, partial closure of epiphysis on medial side resulted in genu varum of 20 degrees, which was treated with medial open wedge osteotomy of the proximal tibia combined with resection of a segment from the proximal fibula, and a percutaneous epiphysiodesis of the proximal tibia and fibula. At three years follow up, the child had shortening of the leg by 1 cm, but no angular deformity. Significance of regular follow-up after an epiphyseal injury to detect the condition and role of operative management with various modalities is discussed.

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