Traumatic physeal injuries Retrospective study on 113 cases at Yopougon teaching hospital (Abidjan)

Abstract

Background: African data on physeal injuries are lacking; the current study aimed to describe their anatomic patterns; to discuss treatment options; and to analyze results of treatment.
Patients and Methods: From 2000-2004, a cohort of 113 physeal injuries (76 boys; mean age: 11.5±2.9 years; range: 5-15) was reviewed for demographic and clinical data at our institution. Injuries were classified according to Salter-Harris (SH). In first intention, we treated closely Salter-Harris type 1-2, and surgically the other types and failures of initial reduction. Patients were assessed for union and complications rates at a followup averaged 1.2±0.8 years.
Results: The main injury cause was car accident (56.6%); radial (29.2%) and femoral (28.3%) distal sites were mostlyinvolved; Salter-Harris type 2 predominated (68.1%). Closed reduction was successful in 97 patients (27 SH1, 70 SH2); surgery is indicated in 16 patients of whom 7 (5 SH3, 2 SH4) by primary intention, and 8 (1 SH1, 7 SH2) secondarily. The mean healing index was 59.8 days (upper limb: 44.4;
lower limb: 75.3). Late complications (6.2%) included 3 growth disturbances, 2 stiff knees, 1 painful and 1 stiff ankle. Growth disturbance was statistically correlated to age of patients (p>0.05) but not to fracture site (p<0.05, Fischer exact test).
Conclusion: This series supports that Salter-Harris type 1-2 should be treated closely in first intention while surgical indications should be reserved for Salter-Harris articular types.


Keywords: Physeal injuries , trauma , children.

> African Journal of Paediatric Surgery Vol. 3 (2) 2006: pp. 60-63