Rotational injuries of the distal tibial growth plate

• Published in: Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association Vol. 8; no. 6; pp. 784 - 788
• Main Authors: Nenopoulos, Savas P., Papavasiliou, Vasilios A., Papavasiliou, At. V.
• Format: Journal Article
• Language: English
• Published: Tokyo Elsevier B.V 01.11.2003; Springer; Japanese Orthopaedic Association; Springer Nature B.V
• Subjects: Adolescent; Ankle Injuries - diagnostic imaging; Ankle Injuries - rehabilitation; Biological and medical sciences; Casts, Surgical; Child; Cohort Studies; Distal tibia; Female; Follow-Up Studies; Growth Plate - diagnostic imaging; Humans; Injuries; Injuries of the limb. Injuries of the spine; Injury Severity Score; Male; Medical sciences; Physis; Radiography; Range of Motion, Articular - physiology; Recovery of Function; Rotation; Rotational; Salter-Harris Fractures; Skeletal system; Sports injuries; Tibial Fractures - diagnostic imaging; Tibial Fractures - rehabilitation; Traumas. Diseases due to physical agents; Treatment Outcome; Distal tibia; Physis; Rotational; Injuries; Human; Open reduction; Radiodiagnosis; Diseases of the osteoarticular system; Fracture; Spiral; Trauma; Radiography; Treatment; Tibia; Surgery; Distal; Diagnosis; Bone
• ISSN: 0949-2658; 1436-2023
• DOI: 10.1007/s00776-003-0723-x

Nine rotational injuries of the distal tibial growth plate in combination with spiral fracture of the fibula were treated in our department between 1993 and 2000. The average age of the patients was 12 years. The injury was a result of sudden, forceful external rotation of the ankle and foot. Pain and slight swelling of the ankle and external rotation of the distal tibia of 20°–40° were present. Radiologically, irregularity and widening of the growth plate of the distal tibia were obvious. In all these cases we noted, on lateral views, the characteristic sign of an “open fish mouth,” due to the changes in the shape of the physeal plate. The spiral fracture of the fibula was not obvious in all radiographic views. The treatment in all eight fresh cases was closed reduction and manipulation by reversing the mechanism of injury and long leg cast application in all nine cases (including the one neglected case) for 6–8 weeks. The final results were either excellent or very good in all nine patients after a mean follow-up of 6 years.