Traumatic physeal separations (SH I/II) of the lower extremities are rare. Complications are reported in 2.2-39.6%. The current study is intended to provide recent data concerning epidemiology and treatment decisions in physeal separation of the distal tibia. All patients who suffered a physeal separation of the distal tibia in a 36-month period were included in a multicenter study. Age, gender, mechanism of injury, classification, therapeutic decision, and early complications were recorded online. There were 150 cases (64.6% male, 35.4% female, average age 11.8 years). The most frequent mechanism of injury was sportive activity (42%); 76% of cases needed reduction. Antecurvation was tolerated up to 10° (p=0.0021) and valgus up to 7° (p=0.0155). Tolerance ranges up to 5° of retrocurvation and varus were not statistically significant. The investigation confirmed epidemiological data of former studies. For the first time data concerning the treatment reality of physeal separations of the distal tibia were recorded. They consistently follow the recommendations of the appropriate literature.

Necrotizing fasciitis is a soft tissue infection which is highly lethal. Its lethality can only be reduced by early diagnosis and radical débridement. A delayed diagnosis will result in streptococcal toxic shock syndrome. Any surgery neglecting radical débridement up to amputation is inadequate and cannot reduce lethality. This paper reports on two cases of necrotizing fasciitis of the leg caused by group G streptococci.