[Results of the surgical treatment of ankle fractures in children and adolescents]

Abstract

We present results of treatment in 36 cases of distal tibial epiphyseolysis in 34 patients treated between 1999 and 2005 with a minimal follow up of 12 months (average 28,5, range 13-84 months). The mean age at injury was 12 years (range from 7 to 16). There were 22 cases of type II injury according to the Salter-Harris classification, 5 cases of type VII, 3 of type IV, 2 of type I and two cases of triplane fracture, one case of retrospectively recognised type V and one of type III. 12 children required open reduction and K-wire fixation, the rest of 22 children underwent closed reduction followed by percutaneus fixation in 12 cases. Concomitant fibular fracture occured in 30 cases and required open reduction and fixation in 4. There were 18 good, 14 fair and 3 bad results according to Gleizes. The mean AOFAS scale result was 92.7. One child underwent 2 weeks of intravenous antybiotic therapy to recover from superficial skin infection around percutaneus K-wires. Four cases of physeal bar formation were noted. In two of them distal tibial osteotomy to correct ankle varus was necessary and one underwent bony bridge removal followed by fatty tissue interposition. The remaining physeal bar resulted in 10 degree of ankle valgus without functional dispairement.