Late results in 65 physeal ankle fractures

Abstract

Fifty-nine Salter-Harris III and IV lesions of the medial malleolus, Tillaux fractures, and triplane fractures were examined after 9 (3–32) years to assess the frequency of late symptoms, deformity, joint incongruity, and secondary arthrosis. Six out of 18 Salter-Harris III and IV lesions of the medial malleolus were reduced open, none of which had any signs of growth disturbance, whereas 1 case, left with a 3-mm residual dislocation, had 5 degrees of anterior angulation. Of the 17 Tillaux fractures, ten were not reduced and two of these gave slight symptoms, whereas five openly reduced fractures were asymptomatic at follow-up. Out of 18 triplane fractures, not reduced, two gave slight ankle pain and another had 6 degrees of anterior angulation, whereas three often reduced fractures were symptomatic. The overall results were good and no case of arthrosis, defined as reduction of the joint space, was found in any of the fracture groups despite a follow-up of 12 or more years in one third of the cases.