- See:
Adult Pronation External Rotation Frx:
- Distal Tibia:
- SH type II frx of distal tibial physis is most common pattern:
- metaphyseal fragment is characteristically localized on lateral side or posterolaterally;
- lateral or posterior displacement is also present;
- SH type I frx is occassionally present;
- look for residual valgus deformity;
- Distal Fibula:
- fibular frx has a short oblique course and is approx 4-7 cm from tip of
lateral malleolus;
- Complications:
-
Failure to Achieve Reduction:
- due to soft tissue interposition which leads to valgus deformity;
- a lateral or posterolateral metaphyseal fragment, may get caught behind fibula, complicating attempts at closed reduction;
- may require anterolateral incision, to disengage the metaphyseal spike;
- closed reduction of this frx can sometimes be difficult since this triangular fragment may become jammed between tibia & fibula;
- upto 10 deg of spontaneous remodeling may occur in child < 10 yrs;
- Physeal Arrest:
- may lead to leg length deformity;
Pronation injuries of the ankle in children. Retrospective study of radiographical classification and treatment.
Roentgen stereophotogrammetric analysis of growth pattern after pronation ankle injuries in children.
