Premature Physeal Closure after a Non-Displaced Physeal Fracture of Distal Fibula

Antti Stenroos,Topi Laaksonen,Jussi Kosola,Yrjänä Nietosvaara

doi:10.31487/j.scr.2021.06.08

Abstract

Premature physeal closure (PPC) may lead to clinically significant progressive angular deformity or leg length discrepancy. Many variables seem to play a role in determining which injuries result in PPC. A 8- year-old boy sustained a non-displaced physeal fracture of distal tibia and fibula. He showed no signs of PPC at 7 months post-injury. Seven years later, his ankle became painful. He had developed PPC of distal fibula causing angular ankle deformity, which was treated successfully by corrective osteotomy. To our knowledge, this is the first reported case of a non-displaced fracture of the distal fibula leading to PPC several years after the initial injury, which in our understanding was impossible to predict.

Highlights

Distal tibial and fibular physis are responsible for approximately onethird of the final length of the lower leg producing between 3-5 mm of longitudinal growth per year [1]
Risk of premature physeal closure (PPC) of the injured distal tibial growth plate has varied between 5-42% [3,4,5,6,7]
Our patient probably sustained a non-displaced physeal fracture of the distal fibula from a low energy trauma, which led to a premature physeal arrest and significant angular deformity caused by the shortened fibula

Summary

Introduction

Distal tibial and fibular physis are responsible for approximately onethird of the final length of the lower leg producing between 3-5 mm of longitudinal growth per year [1]. Premature Physeal Closure after a Non-Displaced Physeal Fracture of Distal Fibula Premature physeal closure (PPC) may lead to clinically significant progressive angular deformity or leg length discrepancy. A 8year-old boy sustained a non-displaced physeal fracture of distal tibia and fibula.

Results

Conclusion