title: Distal tibial and fibular epiphyseal fractures in children: prognostic criteria and long-term results in 158 patients.
abstract: From 1974 to 1993, 158 injuries of the ankle joint were treated at the Department of Orthopedics and Traumatology of Santobono Children's Hospital. One hundred thirty-two patients were treated conservatively; 26 patients underwent surgical treatment. Fibular fractures of the malleolus without epiphyseal separation or dislocation (68 patients) were excluded from this review. Of the 158 patients, 113 (70%) were available for follow-up. The mean age of patients was 11 years. The mean follow-up was 6 years (range 3-15 years). In this review, the authors compare, based on the degree of epiphyseal separation or dislocation, the Carothers-Crenshaw classification, which is based on the mechanism of trauma, with the Salter-Harris classification, which is based on anatomical-radiographic criteria. The aim is to review the authors' patients based on these classifications, to verify the prognostic ability of these criteria and thus to establish a better and more viable treatment for these injuries. Therefore, two fundamental factors should be considered for the prognosis: the mechanism of trauma and damage to the epiphyseal plate. Compressive trauma and adduction-supination trauma are the most dangerous types of injury, and any damage or gap in the physis should be perfectly reduced, by open means if necessary, to prevent a bone bridge from forming.
authors.affiliation: Department of Orthopaedics and Traumatology, Santobono Children's Hospital, Napoli, Italy.
authors.forename: N
authors.initials: N
authors.lastname: de Sanctis
authors.forename: S
authors.initials: S
authors.lastname: Della Corte
authors.forename: C
authors.initials: C
authors.lastname: Pempinello
mesh_terms: D016512:Ankle Injuries / Q000145:classification*; D002648:Child; D005360:Fibula / Q000293:injuries*; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000145:classification*; D006801:Humans; D011379:Prognosis; D013978:Tibial Fractures / Q000145:classification*; D013997:Time Factors