Treatment For Displaced >2mm Fractures Of Type ? Pediatric Tibial Distal Epiphyseal Fracture

Objective:To study the clinical effects of displaced >2mm fractures of type? pediatric tibial distal epiphyseal fracture.Method:Totally 87 cases of children with displaced >2mm fractures of type? pediatric tibial distal epiphyseal fracture in our hospital from January 2010 to December 2015.There are 59 males and 28 females aged from 2.4 to 15 years old with an average of(10.4±2.7)years.According to the expectations of the children's parents,initial treatment was closed reduction internal fixation(CRIF),but patients with > 2mm of postreduction displacement were treated with open reduction internal fixation(ORIF).According to Dias and Tachdjian classification,there were 53 patients in supinated group and 34 patients in pronated group.Result: All cases were followed up for 11 to 70 months with an average of(40.5±10.3)months.According to Mazur ankle function assessment,There were excellent in 49 cases,good in 28 cases and poor in 10 cases in the cases treated by surgical method as the excellent of 88.5%.The proportion of incidence of different treatments is statistically distinct.The incidence of ORIF was 59%.Patients with supination type injuries were less likely to have greater residual displacement when compared with their patients with pronation counterparts.Significantly more ORIF were performed in patients with pronation type injuries than supination type injuries(?2=5.114,P=0.024).Finally the functional recovery was excellent,only 6 cases remained shortening and 4 cases remained angular deformity.Conclusion: The distribution of postreduction displacement for displaced >2mm fractures of type ? pediatric tibial distal epiphyseal fracture was associated with treatment modalities,significantly more ORIF were performed in patients with pronation type injuries than supination type injurie.CRIF should be performed first for displaced >2mm fractures of type? pediatric tibial distal epiphyseal fracture unless ORIF fails and have a satisfactory and effective curative effect.Therefore,it is worth promoting and applying in clinic.