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Kurt Oktay A, Oktay KNK, Bulut G, et al. Combining Salter-Harris and Dias-Tachdjian could be better at determining the prognosis of distal tibial physeal fractures. Injury. 2022;doi: 10.1016/j.injury.2022.01.006.
Kurt Oktay, A., Oktay, K. N. K., Bulut, G., & Bekler, H. I. (2022). Combining Salter-Harris and Dias-Tachdjian could be better at determining the prognosis of distal tibial physeal fractures. Injury, . https://doi.org/10.1016/j.injury.2022.01.006
Kurt Oktay, Alper, et al. "Combining Salter-Harris and Dias-Tachdjian could be better at determining the prognosis of distal tibial physeal fractures." Injury vol. (2022). doi: https://doi.org/10.1016/j.injury.2022.01.006
Kurt Oktay A, Oktay KNK, Bulut G, Bekler HI. Combining Salter-Harris and Dias-Tachdjian could be better at determining the prognosis of distal tibial physeal fractures. Injury. 2022 Jan 05; doi: 10.1016/j.injury.2022.01.006. Epub 2022 Jan 05. PMID: 35033354.
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Injury. 2022 Jan 05; doi: 10.1016/j.injury.2022.01.006. Epub 2022 Jan 05.

Combining Salter-Harris and Dias-Tachdjian could be better at determining the prognosis of distal tibial physeal fractures.

Injury

Alper Kurt Oktay, Kubra Neslihan Kurt Oktay, Guven Bulut, Halil Ibrahim Bekler

Affiliations

  1. Kartal Dr. Lutfi Kirdar Training and Research Hospital, Department of Orthopedics and Trauma Surgery, Turkey. Electronic address: [email protected].
  2. Yeditepe University Hospital, Department of Physical Medicine and Rehabilitation, Turkey.
  3. Kartal Dr. Lutfi Kirdar Training and Research Hospital, Department of Orthopedics and Trauma Surgery, Turkey.

PMID: 35033354 DOI: 10.1016/j.injury.2022.01.006

Abstract

OBJECTIVES: The aim of this study is determining the factors that affect prognosis of distal tibial physeal fractures (DTPF) and analyzing whether Salter-Harris (SH) or Dias-Tachdjian (DT) classification is more predictive for outcomes.

METHODS: Patients treated for DTPF were retrospectively analyzed. Fracture patterns were classified according to SH and DT. Treatment methods and fracture characteristics were noted. Distal tibial angles and joint irregularities were analyzed on patient's final ankle radiographs followed by American Orthopedic Foot and Ankle Score questionnaire.

RESULTS: 75 patients followed-up between 6 and 96 months meeting the inclusion criteria were evaluated. Joint irregularity was observed in 41.3% and partial premature physeal closure (PPC) in 34.7% of the patients. Lateral distal tibial angle (LDTA) and talocrural angle related deformity were detected in 20% and 14.7% of the patients, respectively. Partial PPC and joint irregularities that have been developed in pronation-eversion-external rotation and supination-inversion injuries (SH type 3, 4) were 62% and 50%, and 42% and 75%, respectively. On follow-ups of supination-external rotation injuries (SH type 2) joint irregularity has never been observed. Following supination-external rotation and supination-plantar flexion injuries, a low rate of partial PPC have been developed; LDTA related deformity was revealed at a high rate of 39.1% after supination-inversion injuries. There weren't any differences observed between the initial displacement, residual displacement or surgical technique and PPC, joint irregularity and angular deformities. Patients treated by ORIF technique had lower AOFAS scores than patients treated by other surgical techniques.

CONCLUSIONS: In this study it was revealed that SH classification system is not sufficient alone to determine the prognosis of DTPF, the injury mechanisms causing SH types might be also significant in prediction of the prognosis of DTPF.

Copyright © 2022 Elsevier Ltd. All rights reserved.

Keywords: Ankle joint irregularity; Dias-Tachdjian classification; Distal tibial physeal fractures; Physeal fracture; Premature physeal closure; Salter-Harris classification

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