Epiphysial ankle fractures in children

Abstract

Objective: To analyze in a retrospective way, children with fractures on the ankle involving the tibia distal epiphyseal plate, associated or not to the fracture of fibula, about the trauma mechanism, age, type of fracture following the classification of Dias and Tachdjian (1978) and Salter-Harris (1963), treatment and complications in relation to the follow up final result according to clinic-radiographic analysis by American Orthopaedic Foot & Ankle Society (AOFAS), associated to complementary signs. Methods: Forty-two patients were analyzed (43 fractures) between August 1998 and May 2002. Twenty-seven children were masculine, and 15 feminine. The middle age of patients was of 149.90 months (83 to 181 months). We utilized the classification of Dias and Tachdjian and Salter-Harris. The proposed treatment was conservative in 26 patients and surgery-based on 17 cases. Results: The middle of segment was 23.47 months, varying from four to 44 months. The patients were analyzed through AOFAS analysis scale associated to radiographic criteria, being that 28 (65.12%) patients had shown good results, seven (16.28%) regular results and eight (18.60%)revealed themselves in an unsatisfactory way. Conclusion: The good results are directly related to age of children higher than ten years old, to the quick diagnosis of the lesion’s mechanism involving the epiphisary plate, the ready and correct treatment according to the type of fracture (Dias and Tachdjian), distal tibial articular angle under five degrees (valgus or varus) and to the preservation of the growth plate when indicated surgery-based treatment of the fracture.