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Angular deformity development after the distal tibial physeal fractures.

B Özkul, M S Saygılı, E Çetinkaya

    Acta Orthopaedica Belgica
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    Premature physeal closure (PPC) and residual displacement over 2 mm are key indicators for angular deformity after distal tibia physeal injuries. Early detection aids in preventing malalignment.

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    Area of Science:

    • Orthopedic surgery
    • Pediatric orthopedics
    • Pediatric trauma

    Background:

    • Physeal injuries of the distal tibia can lead to angular deformity.
    • Premature physeal closure (PPC) is a radiological sign that can be detected postoperatively.
    • Identifying prognostic factors is crucial for managing these injuries.

    Purpose of the Study:

    • To identify prognostic factors for angular deformity development after distal tibia physeal injuries.
    • To investigate the relationship between premature physeal closure and angular deformity.
    • To evaluate the role of residual displacement and patient age.

    Main Methods:

    • Retrospective analysis of 104 patients with distal tibia physeal injuries.
    • Classification of injuries using the Salter-Harris (SH) system.
    • Analysis of factors including sex, age, injury energy, PPC, residual gap, and deformity.

    Main Results:

    • Angular deformity occurred in 25% of SH Type 2, 60% of Type 3, and 30% of Type 4 patients with PPC.
    • Residual displacement >2 mm, patient age, and PPC were significant risk factors for angular deformity.
    • PPC was associated with higher rates of deformity across different Salter-Harris types.

    Conclusions:

    • Residual displacement exceeding 2 mm and the presence of premature physeal closure are significant predictors of angular deformity.
    • Radiological monitoring for PPC during follow-up is essential for preventing distal tibia malalignment.
    • Age and specific Salter-Harris classifications influence the risk of developing angular deformity.