Angular deformity development after the distal tibial physeal fractures

Published online: Dec 27 2016

Barı? ÖZKUL, Mehmet Selçuk SAYGILI, Engin ÇETINKAYA, Fatih ARSLANO?LU, Ilhan A BAYHAN, Bilal DEMIR, Ali Çağrı TEKIN

Metin Sabanci Baltalimani Bone Diseases, Training and Research Hospital, Department of Orthopaedic Surgery and Traumatology, Turkey


Several clinical and radiological factors can be prognostic in the development of angular deformity following physeal injuries of the distal tibia. One of the radiological parameters, premature physeal closure (PPC), can be detected during postoperative followups. Aim of our study was to identify the prognostic factors in development of angular deformity and its relationship with PPC. One hundred and four patients treated due to physeal injuries of the distal tibia were included in our study. Patients were divided into three groups based on Salter-Harris (SH) classification. The intergroup relationships between sex, age, the amount of energy sustained during injury, premature physeal closure, the amount of residual gap, and deformity were analyzed. Angular deformity developed in 25% (3/12) of SH Type 2, in 60% (9/15) of Type 3 and 30% (3/10) of Type 4 patients with PPC. A residual displacement of more than 2 mm, age and premature physeal closure were specified as significant risk factors for development of angular deformity. 2 mm limit for residual displacement and findings of premature physeal closure in the radiological evaluations during follow-ups are prognostic factors in avoiding malalignment of the distal tibia. Level of evidence: Level 3.