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.