Paediatric Tibia Metaphyseal fractures

Proximal tibial metaphysis

Distal Tibial metaphysis

Proximal tibial metaphysis

There is a risk of valgus deformity occuring following nondisplaced medial proximal tibial metaphyseal fractures. It is thought to be due to asymmetric overgrowth.

Osteotomy should not be performed, because it often precedes recurrence.

Recent literature recommends a conservative approach because the deformity mostly resolves. 

Hemiepiphyseal stapling may play a role.

see Proximal Epiphyseal plate injuries

Distal tibial metaphysis

Often fail into recurvatum, + - varus or valgus angulation

Treatment of Distal

Reduce with foot plantar flexed in above knee cast 3-4 weeks, then convert to below knee with foot plantargrade

Varus 6°, Valgus 10°, Recurvatum 10° acceptable for remodelling

References

Last updated 11/09/2015