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At least 19 recordsLinked to original sources

Operative treatment of displaced Salter-Harris III distal tibial fractures.

Displaced, isolated Salter-Harris III fractures of the distal tibia are infrequent. Typically, the mechanism of injury is an external rotation stress to the adolescent ankle. The distal tibial growth plate fuses from medial to lateral during adolescence. If the anterior tibiofibular ligament remains intact, lateral distal epiphysis of the tibia. Closed reduction of displaced fractures is usually unsuccessful. In 5 displaced fractures, periosteal flaps were frequently found to have blocked closed reduction. Follow-up evaluation after open reduction and internal fixation revealed anatomic healing and normal ankle strength.

Adolescent↗

Growth plate injuries: Salter-Harris classification.

Fracture of the growth plate is an injury unique to childhood. Most such fractures heal without permanent deformity. A small percentage, however, are complicated by growth arrest and subsequent deformity. The Salter-Harris classification of growth plate injuries aids in estimating both the prognosis and the potential for growth disturbance. The Salter-Harris system classifies growth plate fractures into five groups: type I, fracture through the growth plate; type II, fracture through the growth plate and metaphysis; type III, fracture through the growth plate and epiphysis; type IV, fracture through the growth plate, epiphysis and metaphysis, and type V, crush or compression injury of the growth plate.

Biomechanical Phenomena↗

Biodegradable fixation of distal humeral physeal fractures.

Polyglycolic acid (PGA) has been used worldwide as a biodegradable suture material since 1970. Biodegradable polyglycolide implants were introduced in osteofixation of cancellous bone fractures in 1985. From September 1987 to September 1989, 19 consecutive children with physeal fractures of the distal humerus necessitating open reduction and internal fixation were treated by transphyseal biodegradable fixation using 1.5 x 60-mm2 self-reinforced polyglycolide (SR-PGA) pins. Included were nine displaced fractures of the lateral humeral condyle, five severe avulsions of the medial epicondyle of the humerus, four displaced fractures of the humeral capitellum, and one intraarticular fracture of the medial condyle of the humerus. After accurate reduction, two smooth Kirschner pins 1.5 mm in diameter were introduced across the growth plate for temporary fixation. The metallic pins then were removed one by one and subsequently replaced with the cylindrical SR-PGA pins 1.5 mm in diameter. After operation, a padded plaster splint was worn for four weeks. Neither secondary displacement nor signs of growth disturbance were seen during the 26-month follow-up time (mean, 17.2 months). Not only the reduction of the costs but also the psychological aspects should be considered when dealing with biodegradable fixation of physeal fractures in children. Transphyseal biodegradable fixation has established itself as a procedure of choice for handling simple physeal fractures.

Adolescent↗

[Reparative processes of experimental Aitken III lesion. An animal experiment study].

This present study describes the fine structural aspects of experimentally induced defects of the proximal growth plate of the tibia in rabbits as simulation of epi-/methaphyseal fractures. We evaluated two different defect sizes. As important result we find in narrow defects of 0.5 mm no osseous bridging of the epiphyseal plate whereas with 2 mm defects there is partial transphyseal closure. Growth plate cartilage is thus capable of repairing spontaneously smaller defects.

Animals↗

Closed anatomic reduction of a juvenile tillaux fracture by dorsiflexion of the ankle. A case report.

The juvenile Tillaux fracture is a Salter-Harris Type III intraarticular fracture of the ankle in adolescent children whose distal tibial epiphyses are partially closed. Although there is general agreement that the major force of injury is one of external rotation, when closed reduction is attempted for displaced fractures by reversing the direction of this injuring force, i.e., by internal rotation of the foot on the leg as recommended, there is often failure to achieve satisfactory reduction. Consequently, the fracture is often treated by open reduction. Anatomic reduction was achieved and maintained by maximal dorsiflexion of the ankle. This method of treatment seems not to have been suggested before, and the pathway of reduction suggests that plantar flexion is the significant deforming force in this injury.

Ankle Joint↗

Hand and wrist injuries in the preadolescent and adolescent athlete.

In this time when physical prowess has been elevated to such a high level, the prepubescent and adolescent athlete have increased demands for performance placed on their immature musculoskeletal system. Although improved skills may result the athlete is exposed to more injury. Prompt, appropriate treatment of the injury with a controlled return to participation may prevent reinjury and disability. To this end, athletes, parents, coaches, trainers, and team physicians must maintain a close rapport for the benefit of the athlete.

Adolescent↗

Epiphyseal plate fracture-separation of the olecranon: description of one case.

A rare case of traumatic olecranal epiphyseal plate fracture-separation in a patient aged 14 years is described. Non-surgical treatment was not capable of guaranteeing fracture reduction. Thus, internal fixation with tension band wire method, like in fracture of the same type in the adult, was used.

Adolescent↗

Delayed treatment of a malreduced distal femoral epiphyseal plate fracture.

Fractures of the epiphyseal plate are considered rare when compared with the more prevalent injuries found in competitive sports, but the complications associated with this type of trauma are a major concern. The factors affecting the success or failure of healing include the severity of injury, patient age, and the type and expedience of treatment. This case study examines the clinical presentation and treatment of a 15-yr-old high school football player who sustained a displaced, distal femoral epiphyseal Salter II fracture. Primary treatment consisted of nonmanipulative, nonweight bearing knee immobilization. The treatment resulted in malunion, pain, decreased range of motion and physical deformity; therefore, the patient sought a second opinion. On physical exam, the displacement and rotational deformity of the fracture site were unacceptable. The fracture was treated 20 days post-injury via open reduction with internal fixation. On follow-up, the athlete demonstrated radiographic healing, normal physical exam, and no significant leg length discrepancy or deformity. The athlete successfully returned to full competitive sport activity.

Adolescent↗

Sports-related epiphyseal injuries of the lower extremity. An epidemiologic study.

Sports-related epiphyseal injuries in children and adolescents have been becoming more prevalent during recent years. We report 85 patients with epiphyseal fractures of the lower extremity treated in our hospital during the last twenty years, of which 60 were males and 25 females with an average age of 12.6 years (range 4 to 17 years of age). The injuries were sustained during soccer in 28% and during alpine skiing in 26% of the cases, of which the former was responsible for most of the injuries reported in males and the latter for those in females. The most frequently seen localizations were in the distal tibial epiphysis (31 cases), followed by the distal fibula (17) and the proximal tibial epiphysis (15). Of the reported 85 epiphyseal fractures 30 were Salter-Harris type I injuries, 25 type II, 8 type III and 11 were type IV fractures, while 11 were avulsion fractures. Of these patients, 56% were treated surgically, while conservative treatment was chosen for 44% of the patients. Of the 49 patients available for follow-up, complications were documented in 9 instances, including 3 leg length discrepancies, 4 axis deviations, one avascular necrosis of the femoral head and one case of osteomyelitis, of which 6 required corrective surgery.

Adolescent↗

Retrospective study of 38 cases of femur fractures in horses less than one year of age.

Medical records of 38 horses less than 1 year of age and diagnosed as having a fracture of the femoral diaphysis, metaphysis or distal physis were evaluated. Twenty-six foals had fractures of the femoral diaphysis or metaphysis with the most common fracture configuration being comminuted. Twelve foals had distal physeal fractures with the most common fracture configuration being a Salter-Harris type II. Twenty-one foals with fractures of the capital femoral physis, neck or greater trochanter during the same time period were excluded from this study. Surgical repair was attempted in 16 diaphyseal and 2 distal physeal fractures. Most of the diaphyseal fractures were repaired by placing plates on the lateral and cranial surfaces of the bone. Dynamic condylar screw plates or angle blade plates were used for increased bone purchase in 4 foals with short distal fragments. Five foals with distal physeal fractures were treated; 2 were surgically treated by placing an angle blade plate on the lateral cortex, and 3 foals with minimally displaced distal physeal fractures were managed with stall confinement. Eight of the 16 surgically repaired diaphyseal fractures healed. Fracture location and configuration was not a determinant of outcome, but the mean age of foals with successfully repaired diaphyseal fractures was 2 months compared with 4 months for the unsuccessful cases, indicating that the age and size of the foal was important. Long-term follow up revealed that 6 of the 8 successfully repaired diaphyseal fractures had no residual effects of the fracture observed during performance of the horse for its intended use. Only 1 of the 2 surgically repaired distal physeal fractures healed, but this horse was eventually killed because of unthriftiness related to a malabsorption syndrome. Some form of complication developed in 13 of the 18 surgically repaired fractures. Infection was the primary cause of failure. The greatest determinant associated with infection was the inability to control post-surgical seroma formation.

Age Factors↗

Stabilization of a proximal femoral physeal fracture in a filly by use of cancellous bone screws.

A Salter-Harris type-II fracture of the proximal portion of the right femur in a 2-month-old filly was reduced and stabilized with three 6.5-mm-diameter, 100-mm-long cancellous bone screws through a dorsal approach to the right coxofemoral joint. The screws were removed after 11 months because the filly became lame in the affected limb. The surgical wounds dehisced despite preventive measures, most likely because of tightness of skin in the coxal region. Seven years after the original injury, the horse could perform vigorous paddock exercise without any disability. Early internal fixation of proximal femoral physeal fractures in foals can provide a good long-term prognosis.

Animals↗

Aneurysmal bone cyst in a six-month-old dog.

A 6-month-old female Yorkshire Terrier was examined because of acute left forelimb lameness secondary to a Salter-Harris type IV fracture of the lateral condyle of the humerus. Radiography revealed an eccentric, osteolytic lesion in the distal humeral metaphysis associated with a pathologic fracture. The limb was amputated, and the dog recovered. Microscopic examination revealed an extensive zone of hemorrhage and dilated coalescent spaces, which were filled with blood. Hemosiderin-laden macrophages and multinucleated giant cells were observed throughout the stroma. On the basis of clinical, radiographic, and histologic examinations, a diagnosis of aneurysmal bone cyst was made. Aneurysmal bone cysts generally have been detected in 11- to 13-year-old, medium- to large-sized dogs. They can develop secondary to malignant processes.

Animals↗

Fractures of the proximal tibial epiphysis.

Fractures of the proximal tibial epiphysis are rare. A series of twenty-eight fractures classified according to the Salter-Harris method showed that nine were Type II and eight, Type IV. Lawn-mower injuries, a previously unreported mode of injury for this fracture, caused five of the eight Type-IV fractures and were associated with the worst prognosis by far. Two Type-V fractures in the proximal tibial epiphysis, previously unreported, are described.

Accidents, Home↗

Fractures of the distal femoral epiphyses. Factors influencing prognosis: a review of thirty-four cases.

In a review of thirty-four fractures through the distal femoral epiphyseal plate followed for an average of four years, limb-length discrepancy of 2.0 centimeters or more (measured roentgenographically) occurred in 36% and varus or valgus deformity measured as a difference of 5 degrees or more between the involved and uninvolved extremities occurred in 33%. Reconstructive procedures (osteotomy, epiphyseodesis, or both) were required in 20%. Limitation of knee motion (eleven patients), ligament laxity (eight patients), and quadriceps atrophy (five patients) were also observed. Prognoses made on the basis of the Salter-Harris classification alone were not reliable. The development of deformity appears to be related to the degree of initial displacement of the fracture, the exactness of the reduction, and the type of fracture.

Adolescent↗

Our experience with management of epiphyseolysis in children and adolescents.

A total of 58 children is referred to with fractured growth plates of the distal forearm, proximal humerus, radial condyle of humerus, ulnar epicondyle of humerus, distal tibia, proximal tibia and the distal femur. The related injuries are divided in accord with Salter-Harris classification. The treatment of epiphyseolyses is concerned together with summarizing its results and the appropriate experience. In addition, the indications for both conservative and surgical approaches are delimitated in treating these injuries.

Adolescent↗

Our experience with management of epiphyseolysis in children and adolescents.

A total of 58 children is referred to with fractured growth plates of the distal forearm, proximal humerus, radial condyle of humerus, ulnar epicondyle of humerus, distal tibia, proximal tibia and the distal femur. The related injuries are divided in accord with Salter-Harris classification. The treatment of epiphysiolyses is concerned together with summarizing its results and the appropriate experience. In addition, the indications for both conservative and surgical approaches are delimited in treating these injuries.

Adolescent↗

Traumatic lesions of the triradiate cartilage.

Traumatic lesions of the triradiate cartilage (TC) are a rare occurrence and at a high risk for premature closure with consequent acetabular dysplasia and subdislocation of the femoral epiphysis. Based on their experience (5 cases: 2 type II and 3 type V according to the Salter-Harris classification system) and on the literature, the authors affirm that the most significant prognostic factors of this acetabular dysplasia are the age of the patient (under 10 years) and the type of lesion (Salter-Harris type V). After emphasizing how difficult it is to make a diagnosis (which is often made later on), the authors take into consideration some traumatic lesions of the pelvis and hip which by means of different mechanisms may influence the TC: fracture of the ilio- and ischio-pubic branches, fracture of the neck and detachment of the proximal epiphysis of the femur, traumatic dislocation of the hip. These lesions are often the only indirect sign of lesion, even severe ones, of the TC, and require accurate diagnostic testing (ultrasonography, CAT, MRI).

Accidents, Traffic↗