Physeal Growth Arrest after Traumatic Injury of Distal Tibial Physis A Systematic Review and Meta-Analysis

Abstract

Abstract Background Injury to the physis of the distal tibia in children can lead to subsequent growth arrest. This can result in physeal bars, leg-length discrepancies and angular deformities. Aim of the Work Is to review & meta-analysis the distal tibia physeal injury, treatment & how to decrease complications e.g premature physeal closure (PPC), angular deformity & leg length discrepancy. Patients and Methods We considered randomized controlled trials, prospective or retrospective cohort studies and case–control studies that directly compared ORIF to closed treatment of distal tibia physeal fractures in children and reported the rate of PPC. PPC was defined on radiographs by the presence of a bony bar in the distal tibia physis of the injured limb. Participants were young patients below 18 years old who have distal tibial physis fractures treated by closed reduction & internal fixation (CRIF), open reduction & internal fixation (ORIF). Results this systematic review we found that the degree of initial displacement was significant risk factor for growth arrest after physeal fracture of the distal tibia. Therefore, physicians should consider the possibility of growth arrest in patients with severely displaced physeal fractures of the distal tibia. The displaced S-H II distal tibia physeal fractures have a high risk of periosteal entrapment. ORIF is an effective choice of treatment to obtain an anatomical reduction for patients with > 3 mm of initial displacement. However, PPC is a common complication following ORIF. The presence of associated fibula fracture plays an important role in the fracture outcome. Conclusion the degree of initial displacement was significant risk factor for growth arrest after physeal fracture of the distal tibia. Therefore, physicians should consider the possibility of growth arrest in patients with severely displaced physeal fractures of the distal tibia. The displaced S-H II distal tibia physeal fractures have a high risk of periosteal entrapment. ORIF is an effective choice of treatment to obtain an anatomical reduction for patients with > 3 mm of initial displacement. However, PPC is a common complication following ORIF. The presence of associated fibula fracture plays an important role in the fracture outcome.