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Proximal Tibia Epiphyseal Fractures - Pediatric

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Topic updated on 02/08/12 4:51pm
Introduction
  • Can occur as an isolated proximal tibia physeal fracture or as a part of a Type III tibial tubercle fracture 
  • Classify using Salter-Harris System
Presentation
  • Physical exam
    • perform careful neurovascular exam
      • physis is at same level of trifurcation of vessels and there is a risk of vascular compromise with displacement
Treatment
  •  Nonoperative
    • immobilization in long leg cast
      • indicated in Salter-Harris Type I and Type II fractures
  • Operative
    • anatomic reduction and fixation with percutaneous pinning
      • indicated in Salter-Harris Type III and Type IV fractures
      • dont want displacement to affect trifurcation
References
  1. Review of Orthopaedics, 4th Edition, Mark D. Miller, W B Saunders Co, March 2004 
  2. Orthopaedic Knowledge Update 8: Home study syllabus, Edited by Alexander R. Vaccaro, MD 
  3. Miller Colorado Review Lecture Series , Mark D. Miller, Stryker, 2005 
  4. Handbook of Fractures, Joseph D. Zuckerman, Kenneth J. Koval 
  5. Surgical Exposures in Orthopaedics: The Anatomic Approach, Stanley Hoppenfeld, Piet DeBoer
  6. Netter's Concise Atlas of Orthopaedic Anatomy, Frank H. Netter, John A. Craig, Frank H. Netter, John A. Craig, ICOH
  7. Physical Examination of the Spine & Extremities. Stanley Hoppenfeld.Prentice Hall. Copyright 1976

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