Surgical Indications for Distal Tibial Epiphyseal Fractures in Children

Cai, Haoqi; Wang, Zhigang; Cai, Haiqing

doi:10.3928/01477447-20150305-55

Cited by 21 publications

(31 citation statements)

References 17 publications

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“…Most fractures included in our study were minimally displaced, suggesting that preoperative fracture displacement played an important role in the selection of FAPP vs. ORIF. In children the distance of fracture displacement is used as a selection criterion for choosing between closed and open reduction . In a recent study in 286 children, open reduction was selected in patients with >2 mm of fracture displacement, even after closed reduction .…”

Section: Discussionmentioning

confidence: 99%

“…In children the distance of fracture displacement is used as a selection criterion for choosing between closed and open reduction . In a recent study in 286 children, open reduction was selected in patients with >2 mm of fracture displacement, even after closed reduction . Based on our experience, we would recommend FAPP for fractures with minimal displacement.…”

Section: Discussionmentioning

confidence: 99%

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Closed reduction and fluoroscopic‐assisted percutaneous pinning of 42 physeal fractures in 37 dogs and 4 cats*

Boekhout-Ta¹,

Kim

Cross³

et al. 2016

Veterinary Surgery

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Objective: To report complications and clinical outcome of dogs and cats that underwent fluoroscopic-assisted percutaneous pinning (FAPP) of physeal fractures.Study Design: Retrospective study.Animals: Client-owned dogs (n 5 37) and cats (n 5 4). Results: The majority of animals (92%) were classified as full functional outcome. No significant predictors of functional outcome were identified. The overall complication rate was 15% (n 5 6). Elective pin removal rate was 41% (n 5 17). Goniometry and limb circumference measurements of the affected and contralateral limbs were not significantly different in dogs for which measurements were obtained. Seventeen of 18 animals (16 dogs, 2 cats) measured had bone length changes on follow-up radiographs.Conclusion: FAPP is associated with an excellent functional outcome in a narrow selection of fracture configurations, specifically those with minimal displacement and for which anatomical alignment can be achieved with closed reduction.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Closed reduction and fluoroscopic‐assisted percutaneous pinning of 42 physeal fractures in 37 dogs and 4 cats*

Boekhout-Ta¹,

Kim

Cross³

et al. 2016

Veterinary Surgery

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“…The most common and important complication of distal tibia physeal fracture is PPC [21]. As shown in Table 3, the incidence of PPC ranges from 0.5 to 43% [2, 9, 16, 21, 23–26]. The factors that contribute to the development of PPC are still controversial.…”

Section: Discussionmentioning

confidence: 99%

“…Özgür Çiçekli et al, Russo et al, and Leary et al found that PPC was significantly associated with the mechanism of injury [9, 23, 24], while Seel et al found no significant link between the mechanism of injury and PPC [25]. Leary et al demonstrated that the primary fracture displacement had a significant influence on PPC [24], but this was disapproved by other studies [2, 23, 25]. Many studies have confirmed that fibula fracture is an important risk factor for the development of PPC, which furthermore indicates that good anatomical reduction may reduce the rate of PPC [2, 16, 25, 26].…”

Section: Discussionmentioning

confidence: 99%

Cannulated screw and Kirschner fixation for the treatment of medial and lateral malleolar epiphyseal fractures in children: a retrospective study of 36 cases

Jiang

et al. 2019

J Orthop Surg Res

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Background Percutaneous fixation with cannulated screws is an effective method for treating medial malleolar epiphyseal fractures, which comprise a portion of bimalleolar and trimalleolar fractures. Lateral malleolar fractures also need to be fixed to achieve anatomical reduction and absolute stable fixation of the ankle. However, there are no individual studies in the literature on this topic. Methods Thirty-six children (22 boys and 14 girls) aged 8 to 15 years (average, 11.3 years) with medial and lateral epiphyseal fractures were treated by cannulated screw and Kirschner fixation after closed reduction from January 2010 to December 2015 in our hospital. The patients were examined each month postoperatively. Ankle function was assessed using the Baird-Jackson ankle score. Results The 36 patients were followed up for 18 to 29 months (average, 25 months). No cases of fracture non-union or secondary displacement were observed, and the healing time was 2.8 ± 1.1 months (range, 2–4 months). At the last follow-up visit, the Baird-Jackson ankle score ranged from 83 to 100 (average, 94), including an “excellent” score in 13 cases, a “good” score in 19 cases, a “fair” score in 4 cases, and a “poor” score in 0 cases. The ankle recovered to the pre-injury level of function within 3.5 ± 1.6 months (range, 2–5 months). Dysfunction, pain, instability, and premature epiphyseal closure were not observed during the follow-up of the 36 patients. Conclusions Cannulated screw and Kirschner fixation after closed reduction is an effective and readily available method for the treatment of medial and lateral malleolar epiphyseal fractures in children.

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“…Ozljeda epifi zne ploče rasta (epifi zeoliza) jedan je od prijeloma koji nalažu posebnu kiruršku pozornost. 1,2 Epifi zeoliza distalne tibije druga je prema pojavnosti od svih epifi zeoliza i čini 15 -30% svih prijeloma u djece. 3,4 Važnost ove ozljede ogleda se, osim velike pojavnosti, i u neizvjesnom ishodu cijeljenja, unatoč pravilno provedenom postupku liječenja.…”

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Distal Tibial Epiphyseal Fractures

2018

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Sažetak. Ozljeda epifi zne ploče rasta (epifi zeoliza) jedan je od prijeloma koji nalažu posebnu pozornost. Glavne su mu značajke velika pojavnost i neizvjestan ishod. Unatoč ispravnoj dijagnostici i liječenju epifi zeolize distalne tibije mogu nastati teške komplikacije (zastoj uzdužnog rasta i/ili progresivna deformacija). Budući da su kurativne metode nemoćne kod težih oblika epifi zeoliza, preventivnim mjerama treba barem ublažiti težinu i smanjiti pojavnost ovih ozljeda. Pojavnost i tip prijeloma u djece uvjetovani su brojnim čimbenicima (dob, spol, pretežito ponašanje djece, karakteristika mjesta na kojima djeca borave...), a razlikuju se ne samo od regije do regije već i od grada do grada. U ovom radu analizirano je 197-ero zagrebačke djece koja su od 1. 1. 2010. do 1. 1. 2017. liječena zbog ozljede distalne epifi ze tibije. Zbog nepotpunih podataka iz studije je isključeno 80-ero djece. Ukupno je analizirano 117-ero zagrebačke djece. Njih 37-ero liječeno je u Kliničkome bolničkom centru Zagreb, a 80-ero u Klinici za dječje bolesti Zagreb. U ispitanom uzorku bilo je 88 (69,2%) dječaka i 29 (30,8%) djevojčica. Srednja dob u trenutku ozljeđivanja bila je 12,3 godine, pri čemu su dječaci bili u prosjeku 17 mjeseci stariji od djevojčica. Prema mehanizmima ozljede, većinom se radilo o padovima (58 (49,9%)), a kao najčešća mjesta izdvajaju se sportske površine (36 (30,8%)) te kod kuće (27 (23,1%)). Prema šifri aktivnosti, najčešće su rekreativne (52 (44,4%)) i sportske aktivnosti (47 (40,2%)). Najčešća sportska aktivnost je igranje nogometa. Stoga preventivne mjere treba usmjeriti ponajprije na mušku djecu školske dobi, tijekom sportskih i rekreativnih izvanškolskih aktivnosti, posebice u nogometu. Descriptors: Tibial fractures-classifi cation, epidemiology, etiology; Epiphyses-injuries; Salter-Harris fractures; Growth plate; Accidental falls-statistics and numerical data; Athletic injuries-statistics and numerical data; Accident prevention; Child; Croatia-epidemiology Summary. Distal tibial epiphyseal fractures are signifi cant because they often cause tibial growth disturbance. Distal tibial epiphyseal fractures are the second most common epiphyseal fractures, after distal radial epiphysis. Despite prompt diagnosis and correct treatment, serious complications, such as progressive deformation and permanent disability, are possible. Therefore, it is necessary to prevent these injuries. Prevention is possible only by studying injury pattern, mechanism and locations where fractures occur. In total, medical records of 197 children treated for distal tibia epiphyseal fracture in the period from January 1st , 2010 to January 1st , 2017 were analyzed. Due to insuffi cient data, 80 of them were excluded from the study. Thirty-seven children were treated in Clinical Hospital Center Zagreb and eighty in the Children's Hospital Zagreb. In the studied group of children, there were 81 (69.2%) boys and 36 (30.8%) girls. The average age at the time of injury was 12.3 years, with boys being on average 17 months older than girl...

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Surgical Indications for Distal Tibial Epiphyseal Fractures in Children

Cited by 21 publications

References 17 publications

Closed reduction and fluoroscopic‐assisted percutaneous pinning of 42 physeal fractures in 37 dogs and 4 cats*

Closed reduction and fluoroscopic‐assisted percutaneous pinning of 42 physeal fractures in 37 dogs and 4 cats*

Cannulated screw and Kirschner fixation for the treatment of medial and lateral malleolar epiphyseal fractures in children: a retrospective study of 36 cases

Distal Tibial Epiphyseal Fractures

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