[Traumatic lesions of the proximal tibial epiphysis]

36 fractures of the tibia involving the proximal tibial epiphyseal cartilage were treated in 35 patients at the Accident Hospital Lorenz Böhler, Vienna over a ten-year period from 1980 to 1989. The average age at injury was 13.2 years. Most common concomitant injuries were ruptures of the ACL and/or MCL associated with meniscal lesions in type III- and IV-fractures and fractures of the fibula in type II injuries. We saw two associated aggravating problems as defined by a compartment-syndrome of the lower leg with one immediate peroneal-nerve palsy, but lesion or disruption of the popliteal artery was not observed. 26 patients were treated conservatively and nine patients had to be operated on. Long-term follow-up (means 6.4 years) was available in 28 cases. Premature epiphyseal closure was seen in three cases and one of them developed an axis angulation in the sense of genu recurvatum but operative correction was not necessary. Unsatisfactory results were stated in four cases due to their knee instability or posttraumatic painful arthrosis. There was no case of growth disturbance with axis deformation or angulation requiring surgical revision.