Factors Influencing Premature Physeal Closure following Physeal Injury of the Ankle in Children

Abstract

Purpose:To evaluate the factors influencing premature physeal closure (PPC) following physeal fractures of the ankle in children. Materials and Methods: Forty-eight children with physeal injuries of the ankle were analyzed retrospectively after a minimum follow-up of 1 year. We undertook statistical analysis according to age, gender, cause, fracture type, mechanism of injury, and treatment methods for incidence of PPC. Results: Ten fractures (28.3%) were complicated by PPC. There were three cases of leg length discrepancy (LLD) more than 2 cm, five cases of angulation with LLD more than 2 cm, and two cases of fibula shortening. There were no correlation between PPC and age, sex, cause, or injury mechanism (p＞0.05). There was a statistically significant correlation between the rate of PPC and treatment methods (p=0.018). Conclusion: 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.