[Proximal tibial growth plate trauma in childhood and options for its management].

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Abstract

[Indexed for MEDLINE] 18. J Pediatr Orthop. 2026 Aug 1;46(7):e618-e625. doi: 10.1097/BPO.0000000000003160. Epub 2025 Nov 13. Risk Factors and Surgical Sequelae of Physeal Arrest in Pediatric Salter-Harris III and IV Medial Malleolus Fractures. Roth OS(1), Gupta A(2), Adebayo T(3), Tretiakov M(3). Author information: (1)University of Washington School of Medicine. (2)Biostatistics, Epidemiology, and Analytics in Research Core, Seattle Children's Hospital. (3)Department of Orthopaedics and Sports Medicine, Seattle Children's, Seattle, WA. BACKGROUND: Pediatric medial malleolus fractures pose a risk for physeal bar formation and growth disturbances. This study aimed to determine the rate of physeal bar formation following Salter-Harris (SH) III or IV medial malleolus fractures and identify patient, fracture, and management factors predictive of bar formation. A secondary objective was to evaluate the rate of additional surgeries required in the event of physeal bar formation. METHODS: A retrospective review was performed of 161 patients (age 16 y or younger) with isolated medial malleolus or bimalleolar fractures. Fifty-six skeletally immature patients (39% female) with SH III or IV medial malleolus fractures and ≥6 months of radiographic follow-up met the inclusion criteria. Demographics, injury mechanism, fracture management, and secondary surgeries were recorded. Radiographs were analyzed for fracture displacement, SH classification, coronal plane physeal involvement, anterior and lateral distal tibial angles, postreduction displacement, and physeal bar formation. Wilcoxon rank sum tests assessed statistical significance (α