[Correction of the leg axis after epiphyseal fracture and progressive abnormal growth of the proximal tibia].
Development of an angular deformity around the knee joint, following a posttraumatic premature epiphyseal closure is a rare but serious complication. We present a case report of this complication following a proximal tibial epiphyseal injury in a 9 year old child initially treated conservatively with plaster immobilization. Subsequently, partial closure of epiphysis on medial side resulted in genu varum of 20 degrees, which was treated with medial open wedge osteotomy of the proximal tibia combined with resection of a segment from the proximal fibula, and a percutaneous epiphysiodesis of the proximal tibia and fibula. At three years follow up, the child had shortening of the leg by 1 cm, but no angular deformity. Significance of regular follow-up after an epiphyseal injury to detect the condition and role of operative management with various modalities is discussed.
Universitätsklinik für Unfallchirurgie, Anichstrasse 35, A-6020 Innsbruck. manfred.waldegger@uklibk.ac.at
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Waldegger
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Huber
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Kathrein
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Sitte
D002370:Casts, Surgical; D002648:Child; D004838:Epiphyses / Q000254:growth & development / Q000293:injuries / Q000601:surgery*; D005360:Fibula / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology; D007870:Leg Length Inequality / Q000209:etiology*; D008297:Male; D010027:Osteotomy; D011859:Radiography; D013977:Tibia / Q000254:growth & development*; D013978:Tibial Fractures / Q000150:complications* / Q000601:surgery; D013997:Time Factors