Die reife Two- und Triplane-Fraktur

Abstract

Physiologic closure of the growth plate of the distal tibia occurs between the ages of 12 and 14 years in girls and 1 year later in boys. The closure of the tibial physis starts eccentrically at the ventrolateral zone of the medial malleolus extending dorsally and ends laterally. Therefore, the anterolateral zone is the last to ossify. The process of closure lasts about 18 months. During this period the growth plate loses its joint-protective function and transitional fractures may occur. The more the closure progresses the more lateral the location of the fracture. In addition to the typical transitional fractures, typical fracture patterns of adults in the ossified physis are possible due to a mature bone structure. We report two cases of transitional fractures combined with typical fracture patterns of adults due to a dorsomedial ossified physis in the distal tibia.

Surgical Fixation of Bilateral Simultaneous Avulsion Fractures of the Proximal Tibia in a 12-Year-Old with History of Conservatively Managed Unilateral Tibial Avulsion Fracture

“…Since the partially closed epiphysis is an indicator for high skeletal maturity, limb length discrepancies and angular deformities are not expected posttraumatically [31]. Omar et al [32] describe these injuries as “transitional fractures,” which should be differentiated from true Salter-Harris fractures because the tibia is reaching skeletal maturity.…”

Simultaneous Bilateral Transitional Fractures of the Proximal Tibia after Minor Sports Trauma

“…While fractures of the infantile and adolescent distal tibia are common [8], the proximal tibia is rarely involved. Reported incidences vary from 0.5% to 3% of all epiphyseal fractures [1–4].…”

“…Since the partially closed epiphysis is an indicator for high skeletal maturity, limb-length discrepancies and angular deformities are not expected posttraumatically [8]. In turn, this has consequences on the choice of therapy.…”