Abstract:Background: Pediatric long-bone physeal fractures can lead to growth deformities. Previous studies have reported that physeal fractures make up 18–30% of total fractures. This study aimed to characterize physeal fractures with respect to sex, age, anatomic location, and Salter–Harris (SH) classification from a current multicenter national database. Methods: A retrospective cohort study was performed using the 2016 United States National Trauma Data Bank (NTDB). Patients ≤ 18 years of age with a fracture of the… Show more
“…The presentation demographics of physeal fractures and fracture characteristics in the current study were consistent with previous studies. 7,8,[11][12][13][14] Physeal injuries were more common in males in this study cohort, as reported by others. 1,3,7,8,14 The average age of physeal injury to the distal tibia, proximal tibia, and distal femur was 11.3 years, which coincides approximately with the pubertal growth spurt.…”
Section: Discussionsupporting
confidence: 88%
“…7,8,[11][12][13][14] Physeal injuries were more common in males in this study cohort, as reported by others. 1,3,7,8,14 The average age of physeal injury to the distal tibia, proximal tibia, and distal femur was 11.3 years, which coincides approximately with the pubertal growth spurt. Kawamoto et al reported the mean ages of injury onset at 10.3 years in boys and 8.9 years in girls, and Peterson et al reported peak ages between 11 and 14 years.…”
Section: Discussionsupporting
confidence: 88%
“…The predominance of physeal injuries occurs in males, and the most common type of physeal fracture is classified as Salter-Harris (SH) Type II. 1,3,7,8 Physeal injuries peak between the ages of 11 to 14 years and are commonly sustained during involvement in organized sports. 7,8 Although upper extremity physeal fractures are the most common, physeal fractures of the distal tibia, proximal tibia, and distal femur have the greatest propensity for growth disturbances and complications such as growth arrest.…”
mentioning
confidence: 99%
“…1,3,7,8 Physeal injuries peak between the ages of 11 to 14 years and are commonly sustained during involvement in organized sports. 7,8 Although upper extremity physeal fractures are the most common, physeal fractures of the distal tibia, proximal tibia, and distal femur have the greatest propensity for growth disturbances and complications such as growth arrest. 1,[9][10][11] SH classification and fracture displacement have been shown to be potential risk factors for complications necessitating surgical intervention in physeal fractures of the distal femur.…”
Introduction:Childhood fractures involving the physis potentially result in premature physeal closure that can lead to growth disturbances. Growth disturbances are challenging to treat with associated complications. Current literature focusing on physeal injuries to lower extremity long bones and risk factors for growth disturbance development is limited. The purpose of this study was to provide a review of growth disturbances among proximal tibial, distal tibial, and distal femoral physeal fractures.Methods:Data were retrospectively collected from patients undergoing fracture treatment at a level I pediatric trauma center between 2008 and 2018. The study was limited to patients 0.5 to 18.9 years with a tibial or distal femoral physeal fracture, injury radiograph, and appropriate follow-up for determination of fracture healing. The cumulative incidence of clinically significant growth disturbance (CSGD) (a growth disturbance requiring subsequent physeal bar resection, osteotomy, and/or epiphysiodesis) was estimated, and descriptive statistics were used to summarize demographics and clinical characteristics among patients with and without CSGD.Results:A total of 1,585 patients met the inclusion criteria. The incidence of CSGD was 5.0% (95% confidence interval, 3.8% to 6.6%). All cases of growth disturbance occurred within 2 years of initial injury. The risk of CSGD peaked at 10.2 years for males and 9.1 years for females. Complex fractures that required surgical treatment, distal femoral and proximal tibial fractures, age, and initial treatment at an outside hospital were significantly associated with an increased risk of a CSGD.Discussion:All CSGDs occurred within 2 years of injury, indicating that these injuries should be followed for a period of at least 2 years. Patients with distal femoral or proximal tibial physeal fractures that undergo surgical treatment are at highest risk for developing a CSGD.Level of evidence:Level III Retrospective Cohort Study.
“…The presentation demographics of physeal fractures and fracture characteristics in the current study were consistent with previous studies. 7,8,[11][12][13][14] Physeal injuries were more common in males in this study cohort, as reported by others. 1,3,7,8,14 The average age of physeal injury to the distal tibia, proximal tibia, and distal femur was 11.3 years, which coincides approximately with the pubertal growth spurt.…”
Section: Discussionsupporting
confidence: 88%
“…7,8,[11][12][13][14] Physeal injuries were more common in males in this study cohort, as reported by others. 1,3,7,8,14 The average age of physeal injury to the distal tibia, proximal tibia, and distal femur was 11.3 years, which coincides approximately with the pubertal growth spurt. Kawamoto et al reported the mean ages of injury onset at 10.3 years in boys and 8.9 years in girls, and Peterson et al reported peak ages between 11 and 14 years.…”
Section: Discussionsupporting
confidence: 88%
“…The predominance of physeal injuries occurs in males, and the most common type of physeal fracture is classified as Salter-Harris (SH) Type II. 1,3,7,8 Physeal injuries peak between the ages of 11 to 14 years and are commonly sustained during involvement in organized sports. 7,8 Although upper extremity physeal fractures are the most common, physeal fractures of the distal tibia, proximal tibia, and distal femur have the greatest propensity for growth disturbances and complications such as growth arrest.…”
mentioning
confidence: 99%
“…1,3,7,8 Physeal injuries peak between the ages of 11 to 14 years and are commonly sustained during involvement in organized sports. 7,8 Although upper extremity physeal fractures are the most common, physeal fractures of the distal tibia, proximal tibia, and distal femur have the greatest propensity for growth disturbances and complications such as growth arrest. 1,[9][10][11] SH classification and fracture displacement have been shown to be potential risk factors for complications necessitating surgical intervention in physeal fractures of the distal femur.…”
Introduction:Childhood fractures involving the physis potentially result in premature physeal closure that can lead to growth disturbances. Growth disturbances are challenging to treat with associated complications. Current literature focusing on physeal injuries to lower extremity long bones and risk factors for growth disturbance development is limited. The purpose of this study was to provide a review of growth disturbances among proximal tibial, distal tibial, and distal femoral physeal fractures.Methods:Data were retrospectively collected from patients undergoing fracture treatment at a level I pediatric trauma center between 2008 and 2018. The study was limited to patients 0.5 to 18.9 years with a tibial or distal femoral physeal fracture, injury radiograph, and appropriate follow-up for determination of fracture healing. The cumulative incidence of clinically significant growth disturbance (CSGD) (a growth disturbance requiring subsequent physeal bar resection, osteotomy, and/or epiphysiodesis) was estimated, and descriptive statistics were used to summarize demographics and clinical characteristics among patients with and without CSGD.Results:A total of 1,585 patients met the inclusion criteria. The incidence of CSGD was 5.0% (95% confidence interval, 3.8% to 6.6%). All cases of growth disturbance occurred within 2 years of initial injury. The risk of CSGD peaked at 10.2 years for males and 9.1 years for females. Complex fractures that required surgical treatment, distal femoral and proximal tibial fractures, age, and initial treatment at an outside hospital were significantly associated with an increased risk of a CSGD.Discussion:All CSGDs occurred within 2 years of injury, indicating that these injuries should be followed for a period of at least 2 years. Patients with distal femoral or proximal tibial physeal fractures that undergo surgical treatment are at highest risk for developing a CSGD.Level of evidence:Level III Retrospective Cohort Study.
“…In addition, two general studies provide insight into a broad pediatric fracture population. Fuchs et al [ 22 ] analyzed all physeal long-bone fractures registered in the United States in 2016. Almost 6% of pediatric long-bone fractures involved the physis.…”
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