Trauma involving the proximal tibial epiphysis

Thirty injuries involving the proximal tibial epiphysis were treated during a period of 28 years. The epiphysis was displaced in 16 cases (53%). Three patients presented with peripheral ischemia on admission, and one patient with associated ipsilateral femoral fracture developed delayed thrombosis of the popliteal artery. The treatment results were satisfactory in 21 of the 27 (74%) who were reassessed according to Shelton's evaluation criteria after an average post-traumatic interval of 11.6 years. Three of the six patients with unsatisfactory outcome had a discrepancy in leg length of more than 2.5 cm after concomitant ipsilateral fracture of the femur or the tibia. One patient had a positive 3-cm anterior drawer sign, one patient had a 10 degree valgus deformity of the tibia, and one had to undergo above-knee-amputation because of delayed diagnosis of the vascular lesion.