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Updated: Jun 24, 2026
Creating Rigidly Stabilized Fractures for Assessing Intramembranous Ossification, Distraction Osteogenesis, or Healing of Critical Sized Defects
Published on: April 11, 2012
Management of distal tibial medial malleolus type-6 physeal fractures
Hamlet A Peterson1, F Stig Jacobsen
1Department of Orthopedics, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA, Peterson.hamlet@mayo.edu.
Purpose:
Type 6 is an open fracture in which part of the physis is missing. It is the least common physeal fracture, but has the highest rate of complications, particularly the formation of a physeal bar. Without preemptive treatment, a physeal bar always forms, producing growth retardation and angular deformity, and excision of these physeal bars has been uniformly unsuccessful. The distal medial malleolus is a common site for the fracture.
Methods:
Strategies for the treatment of two varieties of acute medial malleolar type-6 fractures and two types of late deformities following type-6 fracture are given. The acute fractures were treated with either fat or cartilage applied to the exposed physis. The late deformities were treated with corrective iliac bone grafting.
Results:
The acute fractures were prevented from forming physeal bars and the two late deformities were fully corrected with good outcomes.
Conclusion:
Fat applied to an acute type-6 physeal fracture has a good chance of preventing bar formation. Ankle deformities due to bars can be corrected by means of iliac bone grafting.
