title: Periosteal tension band fixation of a pronation external rotation type fracture of the ankle in a child.
abstract: Interposed soft tissues can block the anatomical reduction of displaced physeal fractures in children and may necessitate surgical removal. The authors describe a new technique in which they surgically freed the interposed distal-based periosteal flap in an irreducible Salter-Harris type II fracture in a 6-year-old boy and then used this flap in a tension band mode to stabilize the fracture. The thick periosteal flap was held under tension and was reattached to the tibial metaphysis using a 3.5-mm cortical screw and a multi-spiked soft tissue washer. The fracture healed satisfactorily, and the patient regained his ankle function and range of motion by 2 months. Periosteal tension band fixation achieves good skeletal stabilization and avoids more than 1 surgical incision.
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Royal Victoria Infirmary, 6 Waterbury Rd, Newcastle upon Tyne, NE3 5AJ, UK. bijusankar@doctors.org.uk
authors.forename: Biju
authors.initials: B
authors.lastname: Sankar
authors.forename: Noel Yongshen
authors.initials: NY
authors.lastname: Lee
authors.forename: Philip David
authors.initials: PD
authors.lastname: Henman
mesh_terms: D064386:Ankle Fractures; D002648:Child; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D010521:Periosteum / Q000601:surgery; D011403:Pronation; D012399:Rotation; D013978:Tibial Fractures / Q000601:surgery*