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ISSN 2007-8560 (Print)
Órgano Oficial de Difusión Científica de la Federación Mexicana de Colegios de Ortopedia y Traumatología, A.C. (FEMECOT)

2009, Number 3

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Ortho-tips 2009; 5 (3)

Lesiones fisarias de la tibia distal

Cuevas DAC

Language: Spanish
References: 17
Page: 279-285
PDF size: 110.71 Kb.


ABSTRACT

Ankle injuries in skeletally immature patients are becoming more frequent. However, in many cases they are not diagnosed and therefore treated by a wrong method resulting in long term disability and injury sequels. The system most widely used to classified this kind of injuries was the one developed by Salter and Harris (SH).
When a teenager presents an ankle sprain, always should be suspected as a physeal fracture. Although simple x-ray ankle projections seem to be normal, it is recommended to get an x-ray under stress to discover some instability and in many cases CTs, MRI or a Tridimensional reconstruction to search for complex injuries as a Tillaux fracture. Commonly, SH injuries type I and II should be treated by closed reduction and immobilization with cast. Type III and IV are preferably dealt by open reduction and internal fixation to ensure proper alignment. The most common complication of this injury is premature closure of the physes.


REFERENCES

  1. Barmada A, Gaynor T, Mubarak S. Premature physeal closure following distal tibia physeal fractures. A new radiographic predictor. J Pediatr Orthop 2003; 23: 733–739.

  2. Beaty J, Kasser JR. Roockood & Wilkins. Fractures in Children. 5th edition. 2003.

  3. Diaz LS, Tachdjan MO. Physeal injuries of the ankle in children. Cl Orthop 1978; 136: 230-233.

  4. Ferran N, Oliva F, Mafulli N. Ankle Instability. Sports Med Arthrosc Rev 2009: 17(2).

  5. Harris J. Physeal injuries contemporary diagnostic. Radiology 2005; 28: 1-6.

  6. Horn D, Crisci K, Krug M, Pizzutillo, P, MacEwen D. Radiologic evaluation of juvenile Tillaux fractures of the distal tibia. J Pediatr Orthop 2001; 21: 162-164.

  7. Karrholm J. The triplane fracture: Four years of follow-up of 21 cases and review the literature. J Pediatr Orthop 1997; 6B: 91-102.

  8. Leary J, Handling M, Talerico M, Yong L, Bowe JA. Physeal fractures of the distal tibia predictive factors of premature physeal closure and growth arrest. J Pediatr Orthop 2009; 29: 356-Y361.

  9. Letts M, Davidson D. Surgical management of chronic lateral ankle instability in adolescents. J Pediatr Orthop 2003; 23: 392–397.

  10. Marsh J, Daigneault J, Polzhofer G. Treatment of ankle instability in children and adolescents with a modified chrisman-snook repair a clinical and patient-based outcome study. J Pediatr Orthop 2006; 26: 94–99.

  11. Marsh J, Daigneault J. Ankle Injuries in the pediatric population. Curr Opin Pediatr 2000; 12: 52–60.

  12. Morrissy R, Weinstein S. Lovell and Winter´s Pediatric Orthopaedics Sixth Edition L.W.W. 2006.

  13. Nenopoulos S, Papavasiliou V, Papavasiliou A. Outcome of physeal and epiphyseal injuries of the distal tibia with intra-articular involvement. J Pediatr Orthop 2005; 25: 518–522.

  14. Rohmiller M, Gaynor T, Pawelek J, Mubarak S. Salter I and II fractures of the distal tibia: Does mechanism of injury relate tl premature physeal closure? J Pediatr Orthop 2006; 26: 322-328.

  15. Seifert J, Matthes G, Hinz P, Paris S, Mutze S, Ekkernkamp A, Stengel D. Role of magnetic resonance imaging in the diagnosis of distal tibia fractures in adolescents. J Pediatr Orthop 2003; 23: 727–732.

  16. Yoshida T, Wook-Cheol K, Tsuchida Y, Hirashima T, Oka Y, Kubo T. Experience of bone bridge resection and bone wax packing for partial growth arrest of distal tibia. J Orthop Trauma 2008; 22: 142–147.

  17. Wenger RD, Pring EM. Rang´s children´s fractures. Third Edition 2005 L.W.W.




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