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Published on: April 11, 2012
Premature Physeal Closure Following Pediatric Ankle Physis Fractures: A Retrospective Epidemiological Cohort Study
Silvia Valisena1, Giacomo de Marco1, Oscar Vazquez1
1Pediatric Orthopedics Unit, Service of Pediatric Surgery, Department of Women, Children, and Adolescents, Geneva University Hospitals, Geneva, Switzerland.
Background:
Since there is no consensus on the risk factors of premature physeal closure (PPC) or on its incidence after pediatric ankle physis fractures, we studied these issues.
Methods:
We retrospectively analyzed a cohort of children younger than 16 years admitted to a single university hospital in Switzerland for an ankle physis fracture between 2004 and 2023. Demographic and radiological data were collected, fractures were classified using the Salter-Harris (SH) and Dias-Tachdjian classifications, and statistical analyses included the Fisher exact test for the statistical significance of correlations.
Results:
Twenty-eight (13%) of the 211 patients included (mean age = 12.7 years) experienced PPC. SH II fractures were the most common across the whole population and the subgroups with and without PPC. PPC required surgery in 12/28 cases because it was accompanied by a leg-length discrepancy or joint malalignment. The onset of PPC showed statistically significant correlations for younger age (p < 0.021), SH IV fractures (p < 0.047), and prereduction physeal gaps > 2 mm (p < 0.002).
Conclusion:
The risk of growth disorders after ankle physis fractures is low, but younger age, prereduction physeal gap, and SH IV fractures seem to constitute risk factors for PPC. Proving the statistical correlations between these potential risk factors and PPC will require larger populations.
Level Of Evidence:
III, retrospective cohort study. See Instructions for Authors for a complete description of levels of evidence.
