title: Posttraumatic pediatric distal tibiofibular synostosis: a case report.
abstract: BACKGROUND
  Posttraumatic pediatric distal tibiofibular synostosis is a rare complication of fractures at this level, unreported at this time. Implications include limb length discrepancy, angular malalignment, and gait and biomechanical abnormalities.
  
  
  METHODS
  The authors present a case report of this complication in a 7-year-old child and review the relevant English literature. The patient was treated for a closed distal tibia-fibula fracture and developed a synostosis at that level, with valgus malalignment of the ankle joint. The synostosis was resected and latest follow-up 16 months postresection showed near normalization of the ankle malalignment. Possible etiologies, the anatomical and functional ramifications, and treatment recommendations for this condition are discussed.
  
  
  CONCLUSIONS
  Posttraumatic tibiofibular synostosis is a rare complication that has a potential effect on limb length and alignment, both at the ankle and the knee in the skeletally immature patient. Prevention, early recognition, and prompt treatment prevent the anatomic and functional abnormalities that could result from it.
authors.affiliation: Department of Orthopedics, The University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, NJ 07103, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Munjal
authors.forename: Shyam
authors.initials: S
authors.lastname: Kishan
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Sabharwal
mesh_terms: D016512:Ankle Injuries / Q000150:complications*; D002648:Child; D005260:Female; D005360:Fibula / Q000293:injuries*; D005593:Fracture Fixation, Internal / Q000379:methods; D005596:Fractures, Closed / Q000150:complications*; D017759:Fractures, Malunited; D006801:Humans; D013580:Synostosis / Q000209:etiology*; D013977:Tibia / Q000293:injuries*