![]() ![]() 1) or avulsive injuries of the metaphyseal corners of the tibia are highly suggestive of non-accidental injury, so appropriate investigative protocols must be followed in such situations. Traumatic injuries prior to the start of the gait ( Fig. In the case of a history of pain and limping, differential diagnoses such as musculoskeletal infection, bone tumour, and rheumatologic or haematologic diseases should be ruled out. 2Ĭare must be taken when verifying that the medical history is concordant with the findings of the physical examination. 4 The distal tibial physis is the third most common site of physeal injury (approximately 11%). ![]() The other is protecting the physis in order to avoid deformities or length differences following growth progression, 3 given that the distal tibial physis constitutes approximately 45% of the ankle’s length. 2 One of the primary treatment objectives is re-establishing joint congruence and functional alignment in order to avoid osteoarthritis. 1 Their highest incidence is between the ages of eight and 15 years, and most are associated with sports activities. 2 They are twice as common in boys than in girls. 1 Ankle fractures account for approximately 5.5% of fractures in paediatric patients, and 15% of physeal injuries. The tibia, fibula, and wider distal metaphyseal region of a child’s ankle have a series of unique compositional and physiological characteristics associated with developing bone tissue that result in specific morphological fractures patterns. ![]()
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