[Surgical treatment of fractures of the distal tibia in adolescents].
OBJECTIVE
Injury to the epiphyseal cartilage during the period of growth plate closure in adolescence results in specific stereotyped injury patterns due to the change in biomechanics. According to the number of fragments, fractures of the distal tibia can be categorized into so-called two-plane and triplane I and II fractures. Since these fractures are involving the joint, the most important aspect for further therapy is the reconstruction of the joint surface. As the growth plate has already begun to close at this stage, relevant growth disturbances are unlikely.


METHODS
Fracture dislocation > 2 mm.


METHODS
Undislocated fractures. Usual surgical and anesthetic risks.


METHODS
Closed bone reduction is suitable for most minimally displaced fractures but in uncertain cases with advanced displacement, operative reduction may be necessary. The osteosynthesis can be achieved preferably by cannulated screws which, depending on the localization, can be placed intersecting the growth plate.


METHODS
Basically, plaster immobilization is not necessary in case of stable osteosynthesis. Depending on the patient's cooperation and the fracture stability, a lower-leg cast may additionally be applied. Non-weight bearing for 6 weeks.


RESULTS
While short-term results are generally good, data on long-term outcome and possible development of arthrosis is still insufficient.
Schneidmueller
Dorien
D
Abteilung für Unfall-, Hand- und Wiederherstellungschirurgie, Klinikum der Johann-Wolfgang-Goethe-Universität Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany. dorien.schneidmueller@kgu.de
Marzi
Ingo
I
D000293:Adolescent; D016512:Ankle Injuries / Q000601:surgery*; D001863:Bone Screws; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D050724:Fractures, Cartilage / Q000601:surgery*; D006801:Humans; D008297:Male; D013978:Tibial Fractures / Q000601:surgery*; D016896:Treatment Outcome