Skip Navigation LinksHome > June 2012 - Volume 32 - Issue > Physeal Fractures of the Distal Tibia and Fibula (Salter-Har...
Journal of Pediatric Orthopaedics:
doi: 10.1097/BPO.0b013e318254c7e5
Trauma Supplement

Physeal Fractures of the Distal Tibia and Fibula (Salter-Harris Type I, II, III, and IV Fractures)

Podeszwa, David A. MD*; Mubarak, Scott J. MD

Collapse Box

Abstract

Physeal fractures of the distal tibia and fibula are common and can be seen at any age, although most are seen in the adolescent. An understanding of the unique anatomy of the skeletally immature ankle in relation to the mechanism of injury will help one understand the injury patterns seen in this population. A thorough clinical exam is critical to the diagnosis and treatment of these injuries and the avoidance of potentially catastrophic complications. Nondisplaced physeal fractures of the distal tibia and fibula can be safely treated nonoperatively. Displaced fractures should undergo a gentle reduction with appropriate anesthesia while multiple reduction attempts should be avoided. Gapping of the physis >3 mm after reduction should raise the suspicion of entrapped periosteum that will increase the risk of premature physeal closure. Open reduction of displaced Salter-Harris type III and IV fractures is critical to maintain joint congruity and minimize the risk of physeal arrest.

© 2012 Lippincott Williams & Wilkins, Inc.

The Pediatric Orthopaedic Society of North America (POSNA)
is a group of healthcare professionals, primarily pediatric orthopaedic surgeons, dedicated to advancing musculoskeletal care of children and adolescents. JPO is our official member journal. 
Like us on facebook and become a member today!

Login

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.