Search Our Scientific Publications & Authors

Knee Surg Sports Traumatol Arthrosc 2018 Dec 10. Epub 2018 Dec 10.

Department of Orthopaedic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.

Purpose: Flexion-type Salter-Harris (SH) II fractures of the proximal tibia, also described as Watson-Jones (WJ) IV fractures, are rare injuries reported among adolescent athletes who are close to skeletal maturity and remain elusive. Due to this classification disagreement, the various treatments range from nonoperative to operative types, and no previous studies have explained the mechanisms of injury or the source of the fracture forces. This retrospective matched case-control study aimed to identify radiological factors that are associated with the fracture forces and to elucidate the mechanisms of these injuries. Read More

J Ayub Med Coll Abbottabad 2018 Jul-Sep;30(3):463-467

SUNY Upstate Medical University, United States.

Salter-Harris type I fractures of the distal tibia are commonly seen in paediatrics and management of such fractures follows an algorithm established in the literature. Despite this, osteonecrosis of the distal tibia can subsequently develop. Osteonecrosis or avascular necrosis is cell death that occurs secondary to trauma, metabolic disturbances, sickle cell disease, or medication side effect. Read More

Med J Malaysia 2018 Oct;73(5):342-343

Hospital Tanah Merah, Department of Orthopedic, Kelantan, Malaysia.

Distal femoral physeal fractures in adolescents are often due to high velocity injuries. We present an unusual case of a non-contact distal femoral physeal fracture that occurred during a football match. A torsional force had been directed at the fracture site occurring at the growth plate causing a transverse fracture rather than a spiral fracture. Read More

Emerg Med J 2018 Nov;35(11):679-680

Department of Emergency Medicine, University Hospital Waterford, Waterford, Ireland.

An 11-year-old girl presented with pain and deformity in her right little finger distal interphalangeal joint (DIPJ). She was active in several sports including hurling and had a history of dyspraxia with frequent minor soft tissue injuries which had not required hospital assessment. Her mother was concerned about the possibility of a recent injury. Read More

J Am Acad Orthop Surg 2018 Oct 16. Epub 2018 Oct 16.

From the Wright State University (Mr. Sirois), Boonshoft School of Medicine, the Department of Orthopedics (Dr. Kreul), Wright State University, and the Department of Orthopedics (Dr. Shank), Dayton Children's Hospital, Dayton, OH.

Management of displaced pediatric radial neck fractures can be fraught with challenges. This unique case presents an 11-year-old female with a Salter-Harris type II radial neck fracture and how her radial head overturned 180° with the articular surface facing the radial shaft rather than the capitellum during closed manipulation under anesthesia. The malreduction subsequently required open reduction and highlights the importance of a careful stepwise approach to managing markedly displaced radial neck fractures. Read More

J Am Anim Hosp Assoc 2018 Nov/Dec;54(6):e54603. Epub 2018 Oct 1.

From the Department of Small Animal Medicine and Surgery, University of Georgia, Athens, Georgia (I.R.); and Athens Area Humane Society, Athens, Georgia (J.M.).

A 1 yr old castrated male shih tzu was evaluated for an acute right rear limb lameness and hyphema in the anterior chamber of the right eye. On initial examination, the dog was non-weight bearing on his right rear limb. Ophthalmic examination revealed a centrally located, superficial corneal ulcer in the right eye and blood in the anterior chamber. Read More

Int Orthop 2018 Sep 29. Epub 2018 Sep 29.

Département de l'enfant et de l'adolescent, Service d'orthopédie pédiatrique, Hôpitaux Universitaires de Genève, Rue Willy Donzé 6, 1205, Genève, Switzerland.

Background: Proximal tibial epiphysiolysis (PTE) can have debilitating consequences for young athletes. The mechanism and predisposing factors for this lesion have yet to be determined. To find a common denominator and a biomechanical explanation for PTE, we were using a retrospective analysis of 15 cases in combination with a systematic review of literature. Read More

J Orthop Surg (Hong Kong) 2018 May-Aug;26(3):2309499018801136

1 Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria.

Purpose: Presently, there is no publication combining clinical follow-up with magnetic resonance imaging (MRI) to determine possible post-traumatic alterations following paediatric intra-articular fractures of the medial malleolus. Therefore, the aims of this study were to retrospectively analyze a cohort of patients with Salter-Harris (SH) III and IV fractures of the medial malleolus and to evaluate their long-term outcome. MRI was used to assess possible changes of the articular surface that cannot be diagnosed on native radiographs. Read More

Indian J Orthop 2018 Sep-Oct;52(5):462-469

Department of Orthopaedics, Rutgers New Jersey Medical School, Newark, NJ, USA.

Background: The presence of growth plates at the ends of long bones makes fracture management in children unique in terms of the potential risk of developing angular deformities and growth arrest.

Materials And Methods: We discuss three distinct cases depicting various aspects of physeal injury of the lower extremity in children.

Results: The case illustrations chosen represent distinct body regions and different physeal injuries: Salter-Harris II fracture of the distal femur, Salter-Harris VI perichondrial injury of the medial aspect of the knee region, and Salter-Harris III fracture of the distal tibia. Read More

J Pediatr Orthop B 2019 Jan;28(1):73-78

Department of Orthopedic Surgery, Regional Rheumatoid and Degenerative Arthritis Center, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea.

We observed an unusual type of volar Barton fracture in the pediatric age and performed open reduction and internal fixation of the fragment, using the buttress plate in consecutive children. We report the radiological and clinical outcomes after follow-up for at least 3 years. From March 2008 to September 2014, nine consecutive children were treated by buttress plating. Read More

Acta Ortop Bras 2018 ;26(4):218-221

Health Sciences Division, Universidad de Monterrey, Monterrey, NL, Mexico.

Objective: The aim of this study is to estimate the inter- and intra-observer agreement of the Weiss and Milch classification systems in radiological studies of fractures of the lateral humeral condyle in pediatric patients.

Methods: An agreement study was performed with non-probability sampling of consecutive cases with a sample size of a hundred radiological studies, which were evaluated by three experienced orthopedic surgeons and three resident physicians; following a thorough comparison of both inter- and intra-observer agreements over a six-week period based on the Fleiss' kappa, which was used to determine the inter- and intra-observer agreement rates of both classifications.

Results: The overall reliability of the entire group of evaluators for the Milch classification in the inter-observer evaluation was κ = 0. Read More

J Orthop Sports Phys Ther 2018 Sep;48(9):729

A 13-year-old male gymnast presented via direct access to physical therapy with a chief complaint of insidious-onset right anterolateral shoulder pain that occurred only when performing on the rings and high bar. Following physical examination, the patient was advised to avoid any gymnastic activities that might cause pain while completing stretching and neuromuscular training over the following 2 weeks. Due to continued symptoms, the patient was then referred to an orthopaedist. Read More

Eur J Orthop Surg Traumatol 2018 Aug 27. Epub 2018 Aug 27.

Service of Paediatric Surgery and Paediatric Orthopaedics, Regional Hospital of Bellinzona, Via Ospedale, 6500, Bellinzona, Switzerland.

Background: The technique of intra-focal pinning described by Kapandji is seldom used in paediatric patients. We present our series of paediatric patients treated with Kapandji technique for unstable displaced distal radius fractures.

Methods: We retrospectively reviewed medical records and radiographs of a consecutive series of 56 paediatric patients who underwent closed reduction and fixation with Kapandji technique for unstable displaced metaphyseal and Salter Harris 2 distal radius fractures, from 2008 to March 2018. Read More

Plast Reconstr Surg 2018 Sep;142(3):720-729

Rochester, Minn. From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic.

Background: Salter-Harris fractures of the distal phalanx with or without clinical evidence of nail-bed laceration are frequently undertreated.

Methods: A retrospective review was performed of all patients with distal phalanx Salter-Harris fractures treated between 2004 and 2016.

Results: Seventy patients were treated for 72 Salter-Harris fractures at a mean ± SD age of 11. Read More

J Pediatr Orthop 2018 Sep;38(8):e434-e439

Pediatric Orthopedics and Scoliosis Center, Rady Children's Hospital.

Background: Skeletal trauma is a primary tenet of pediatric orthopaedics. Many high-quality studies have been published over the last few years with substantial relevance to the clinical practice of pediatric orthopaedic trauma. Because of the volume of literature on the subject, this review excludes upper extremity trauma and focuses on the publications affecting the lower extremity. Read More

Ann R Coll Surg Engl 2018 Jun 18. Epub 2018 Jun 18.

Tameside and Glossop Integrated Care NHS Foundation Trust , UK.

Medicine (Baltimore) 2018 Jun;97(24):e11020

CHU Sainte-Justine, Chemin de la Côte Ste-Catherine.

Frequent misdiagnosis of pediatric ankle traumas leads to inappropriate management, which may result in residual pain, instability, slower return to physical activity, and long-term degenerative changes. The purpose of this study was to evaluate the consistency of diagnosis, management, and the treatment of acute lateral pediatric ankle trauma in a tertiary care pediatric hospital. The hypothesis was that the initial diagnosis is often incorrect, and the treatment varies considerably amongst orthopedic surgeons. Read More

J Orthop Sports Phys Ther 2018 Jun;48(6):511

A 14-year-old male football player consulted a sports physical therapist 1 week after being kicked in the front part of his left knee as he was trying to recover an onside kick. Because of these findings in a 14-year-old adolescent, a radiological examination was recommended to rule out a tibia eminence or growth-plate fracture. Radiographs revealed a nondisplaced type III Salter-Harris fracture of the lateral tibial plateau. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2017 Oct;31(10):1195-1199

Department of Traumatology, Affiliated Hospital of Chengde Medical College, Chengde Hebei, 067000, P.R.China.

Objective: To investigate the application value of three-dimensional (3-D) printing technology in the operation of distal tibia fracture involving epiphyseal plate injury for teenagers.

Methods: The retrospective analysis was conducted on the clinical data of 16 cases of children patients with distal tibia fracture involving epiphyseal plate injury undergoing the operation by using of 3-D printing technology between January 2014 and December 2015. There were 12 males and 4 females with an age of 9-14 years (mean, 12. Read More

J Hand Microsurg 2018 Apr 8;10(1):6-11. Epub 2017 Dec 8.

Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, Maryland, United States.

Background: The difficulties in surgical treatment of pilon fractures of the finger include fragment reconstitution and posthealing stiffness. In adults, external fixation with traction and early active range of motion (AROM)/passive range of motion (PROM) during healing is considered necessary for avoiding joint stiffness and attaining realignment. The authors present a unique approach to pediatric pilon fractures that uses open reduction and multivector external fixation with delayed AROM/PROM. Read More

Med Hypotheses 2018 Jun 30;115:65-71. Epub 2018 Mar 30.

Department of Pediatrics and Pathology, Wright State University Boonshoft School of Medicine, Dayton, OH, United States.

Objective: The objective of the present study was to review the histopathology in the original articles by authors Kleinman and Marks that described the specificity of the classical metaphyseal lesion for child abuse and to determine if there were any oversights in the authors' analysis.

Methods: We reviewed the histopathology of the original studies that equated the classical metaphyseal lesion with child abuse. We compared this with the histopathology of metaphyseal fractures caused by known accidental, severe trauma in children and reviewed the histopathology of artifacts that can sometimes be produced in bone histology preparations. Read More

Emerg Med J 2018 May;35(5):335-336

University of Laval, Quebec, Canada.

A short-cut review was carried out to establish the diagnostic accuracy of ultrasound for Salter-Harris type 1 fractures. Three studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. Read More

CJEM 2018 Nov 15;20(6):938-940. Epub 2018 Apr 15.

†Centre intégré de santé et de services sociaux de Chaudière-Appalaches (Centre hospitalier affilié universitaire de l'Hôtel-Dieu de Lévis),Lévis,QC.

Clinical questionWhat is the prevalence of Salter-Harris type I distal fibula fractures in children with lateral ankle injuries?Article chosenBoutis K, Plint A, Stimec J, et al. Radiograph-negative lateral ankle injuries in children occult growth plate fracture or sprain? JAMA Pediatr 2016;170(1):e154114. Read More

Trauma Case Rep 2017 Jun 4;9:22-26. Epub 2017 Jun 4.

King Saud Bin Abdulaziz University for Health Science (KSAU-HS), Head Division Pediatric Orthopedic Surgery, King Abdullah Specialized Children Hospital (KASCH), P.O. Box: 22490, Riyadh 11426, Saudi Arabia.

Background: Although rare, pediatric proximal humerus fractures may coexist with glenohumeral dislocations. Most of these injuries are Salter -Harris type of injuries. The treatment usually consists of closed or open reduction and k- wires fixation. Read More

World J Orthop 2018 Mar 18;9(3):50-57. Epub 2018 Mar 18.

Department of Paediatric Emergency, Chelsea and Westminster Hospital, London SW10 9NH, United Kingdo.

Aim: To determine if ketamine sedation is a safe and cost effective way of treating displaced paediatric radial and ulna fractures in the emergency department.

Methods: Following an agreed interdepartmental protocol, fractures of the radius and ulna (moderately to severely displaced) in children between the age of 2 and 16 years old, presenting within a specified 4 mo period, were manipulated in our paediatric emergency department. Verbal and written consent was obtained prior to procedural sedation to ensure parents were informed and satisfied to have ketamine. Read More

J Knee Surg 2018 Jul 28;31(6):486-489. Epub 2018 Feb 28.

Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota.

Physeal fractures of the distal femoral are rare injuries accounting for less than 2% of all physeal injuries, and tend to have a worse prognosis than similar injuries in other locations. This article reviews the evaluation (including imaging), classification, and treatment of these injuries, and discusses their most important complications and their management, including vascular injury and growth arrest. Read More

Radiol Case Rep 2018 Feb 13;13(1):208-211. Epub 2017 Oct 13.

Department of Radiology, SUNY Upstate Medical University, 750 East Adams Street, Syracuse 13210, NY, USA.

Osteochondroma are the most common benign primary bone tumor. They are bony outgrowths surrounded by a characteristic cartilaginous cap, most commonly arising from the long bones. They are most often asymptomatic, usually discovered as incidental findings before the third or fourth decade of life. Read More

J Hand Surg Asian Pac Vol 2018 Mar;23(1):125-127

* Department of Orthopedics, Hamawaki Orthopaedic Hospital, Hiroshima.

We describe a case of isolated physeal fracture of ulna distal end in a 13-year-old boy. This fracture type is uncommon, especially Salter-Harris type III of this injury has not been reported. Plain radiographs showed a small vertical fracture line at the ulnar distal end and an enlargement of epiphyseal plate at the base of ulnar styloid process. Read More

Semin Musculoskelet Radiol 2018 Feb 6;22(1):95-103. Epub 2018 Feb 6.

Department of Radiology and Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania.

The primary physis is responsible for long bone growth in children and adolescents. Injury and physiologic or metabolic stress to the primary physis present unique radiologic findings that are important for radiologists to recognize and diagnose. Appreciation of the anatomy and histology of the primary physis forms the basis for understanding the imaging findings associated with pathologic conditions affecting the primary physis. Read More

J Pediatr Orthop 2018 Mar;38(3):e128-e132

The Children's Hospital of Philadelphia, Division of Orthopaedics.

Background: Musculoskeletal injuries are among the most common reasons for emergency department (ED) visits in the pediatric population. Many such injuries can be managed with a single follow-up outpatient visit. However, untimely (ie, premature) referrals by emergency physicians to orthopaedic surgeons are common and may inadvertently create need for a second visit, generating unnecessary expenditures. Read More

Am J Emerg Med 2018 Mar 9;36(3):527.e5-527.e7. Epub 2017 Dec 9.

University of Kansas Health System, 3901 Rainbow Blvd, Department of Orthopedic Surgery, Kansas City, KS 66160, United States.

Background: McFarland fracture is the eponym for a rare Salter Harris III or IV fracture involving the medial distal tibia. These fractures can be difficult to diagnose without a high index suspicion and appropriate radiographic imaging. These fractures may result in significant growth disturbances to the pediatric patient. Read More

Arch Bone Jt Surg 2017 Sep;5(5):337-341

Bone Joint and Related Tissues Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Traumatic anterior dislocation of the hip is an extremely rare condition in children and open dislocation is even rarer. This isusually caused by high-energy trauma. In the current study, we present a case of an eight-year-old child suffering from an open anterior-inferior dislocation of the right hip concomitant with pelvic ring disruption and an ipsilateral open distal femoral fracture (Salter-Harris type 4, Gustilo type IIIA) caused by a traffic accident. Read More

Chin J Traumatol 2017 Dec 28;20(6):366-369. Epub 2017 Sep 28.

Department of Orthopaedics, PGIMER, Chandigarh 160012, India.

The physis of a long bone may get 'sandwiched' and crushed between the metaphysis and the epiphysis if it is traumatically loaded along its long axis. Such a physeal injury may lead to complications like angular deformities and growth restrictions and hence, management of such injuries requires adequate planning and attentive execution. Two patients with distal femoral physeal crush injury were treated using a ring fixator such that one ring had the wires passing through the epiphysis and the other through the femoral shaft. Read More

Clin Orthop Surg 2017 Dec 10;9(4):537-541. Epub 2017 Nov 10.

Doi Orthopaedic Clinic, Takatsuki, Japan.

We analyzed three-dimensional (3D) humeral deformity (valgus-varus, flexion-extension, and rotational deformation) after little leaguer's shoulder using 3D computed tomography in a 15-year-old male baseball player. Humeral retroversion was increased by 27.1° on the dominant side compared with the nondominant side. Read More

BMJ Case Rep 2017 Nov 27;2017. Epub 2017 Nov 27.

Department of Orthopaedics, Deenanath Mangeshkar Hospital and Research Centre, Pune, Maharashtra, India.

Fracture of talus with Salter-Harris injury of the distal end of tibia is a rare injury in paediatric age group. The authors report a case of a 13-year-old male child who sustained type IV Salter-Harris injury to the medial malleolus with coronal spilt along with spilt and depressed fracture of the neck of talus and fracture of the lateral process of talus with stable compression fracture of spine sustained due to fall from 6 meters height. CT scan delineated the morphology of fracture pattern and helped in preoperative planning. Read More

Acta Orthop Belg 2016 Dec;82(4):814-820

Several clinical and radiological factors can be prognostic in the development of angular deformity following physeal injuries of the distal tibia. One of the radiological parameters, premature physeal closure (PPC), can be detected during postoperative follow-ups. Aim of our study was to identify the prognostic factors in development of angular deformity and its relationship with PPC. Read More

Adv Med Sci 2018 Mar 26;63(1):107-111. Epub 2017 Oct 26.

Department of Orthopedics, Children's University Hospital of Cracow, Cracow, Poland; Pediatric Surgery Clinic, Department of Orthopedics, Pediatric Surgery Clinic, Jagiellonian University Collegium Medicum, Cracow, Poland. Electronic address:

Purpose: Physeal fractures in children frequently give rise to concerns about the condition of the growth plate. Our observations have proven that the dysfunction of the growth plate is less frequent complication in those cases than misdiagnosed interposition of the periosteum. The aim of this paper is to familiarize the readers with the issue of treatment of physeal fractures of the distal tibia and fibula in the growing skeleton. Read More

BMC Vet Res 2017 Oct 25;13(1):306. Epub 2017 Oct 25.

Surgical and Orthopaedic Research Laboratories (SORL), Prince of Wales Hospital, University of New South Wales, Sydney, Australia.

Background: The physis is the weakest component of immature long bones, and physeal fractures constitute about 30% of fractures in growing dogs. Fractures of the proximal humeral physis typically have a Salter Harris type I or II configuration. These fractures require accurate reduction and adequate stabilization to allow for any potential continued longitudinal bone growth, in conjunction with physeal fracture healing. Read More

Eur J Orthop Surg Traumatol 2018 Apr 19;28(3):503-509. Epub 2017 Oct 19.

Department of Surgery, Section of Orthopedics, Hamad General Hospital, P.O. Box 3050, Doha, Qatar.

Aims: Distal tibia physeal fractures can lead to growth complications such as premature physeal closure (PPC), angular deformity and leg length discrepancy. The aim of our study was to systematically review the literature to assess whether open reduction and internal fixation (ORIF) is associated with lower rates of PPC compared to closed treatment.

Materials And Methods: We searched several databases from 1966 to 2016 for studies that evaluated ORIF versus closed treatment of distal tibia physeal fractures. Read More

Orthop J Sports Med 2017 Oct 10;5(10):2325967117731567. Epub 2017 Oct 10.

Rady Children's Hospital, San Diego, California, USA.

Background: Intra-articular physeal fractures of the distal femur are an uncommon injury pattern, with only a few small case series reported in the literature.

Purpose: To pool patients from 3 high-volume pediatric centers to better understand this injury pattern, to determine outcomes of surgical treatment, and to assess risk factors for complications.

Study Design: Case series; Level of evidence, 4. Read More

Strategies Trauma Limb Reconstr 2017 Nov 16;12(3):159-167. Epub 2017 Oct 16.

Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA.

Salter Harris fractures of the distal femur can lead to growth disturbance with resulting leg length inequality and knee deformity. We have looked at a case series (3) of patients who presented with a distal femur flexion malunion and shortening treated with a distal femoral osteotomy and plating and a proximal femoral osteotomy with a magnetic internal lengthening nail. Does a two-level osteotomy and internal fixation approach provide a reliable result both radiographically and functionally? The average knee extension loss was 12°, LLD 47 mm, PDFA 65°, MAD 2 mm. Read More

Chirurg 2017 Nov;88(11):983-994

Universitätsklinikum Frankfurt, Goethe-Universität, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.

The treatment of pediatric patients in trauma surgery is a special situation in every aspect. For deciding on the correct treatment of fractures of the lower leg and ankle joint, various parameters, such as residual growth rate, skeletal age and height of the patient are decisive. The differences between fractures in children and adolescents are the open epiphyseal plate and the resulting residual growth. Read More

Injury 2017 Oct;48 Suppl 3:S7-S11

Department of Basic Medical Sciences, Neuroscience and Sense Organs, School of Medicine, University of Bari "Aldo Moro", Bari, Italy.

Introduction: The physeal fractures represent the 20-30% of all fractures of the child. The distal tibial physis is the third most frequently injured. The most important complication is the premature physeal closure (PPC). Read More

Clin J Sport Med 2017 Oct 11. Epub 2017 Oct 11.

Advanced Radiology, Baltimore, Maryland.

We report a case series of unilateral Salter-Harris IV fractures of the proximal radial heads in young female gymnasts. To date, there are no previous reports of such injuries in gymnastics. In all 3 athletes, no significant injury preceded presentation or diagnosis. Read More

Radiographics 2017 Oct;37(6):1791-1812

From the Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (J.C.N., B.K.M.); Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (A.C.M.); and Department of Radiology, University of California at San Diego, Rady Children's Hospital and Health Center, San Diego, Calif (J.R.D.).

The growth plates, or physes, are visible on virtually all images obtained in skeletally immature children. The proper function of these growth plates depends on an intricate balance between chondrocyte proliferation, which requires nourishment from the epiphyseal vessels, and chondrocyte death, which requires the integrity of the metaphyseal vessels. Therefore, injury to the growth plate (ie, direct insult) or vascular compromise on either side of the growth plate (ie, indirect insult) can cause growth plate dysfunction. Read More

J Pediatr Orthop 2017 Oct 3. Epub 2017 Oct 3.

Department of Orthopaedic Surgery, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI.

Background: Multiple studies have shown low intrarater and interrater agreement of radiographic classification systems for proximal humerus fractures (PHFs) in adults. There is no standardized method of measuring angulation of pediatric PHFs, nor is there consensus as to the amount of angulation and displacement that require operative fixation of adolescent PHFs. We propose a new standardized method to measure fracture angulation that is similar to the method used to measure the epiphyseal-shaft angle for slipped capital femoral epiphysis. Read More

J Pediatr Orthop B 2018 Jan;27(1):47-51

Department of Orthopaedics, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India.

We report a unique case of post-traumatic avascular necrosis of tibia in a 12-year-old boy following a Salter-Harris type II physeal injury of the proximal tibia. The diagnosis was made on the basis of classical radiological findings. The only clinical symptom was diffuse shin pain. Read More

J Surg Case Rep 2017 Aug 22;2017(8):rjx166. Epub 2017 Aug 22.

Departments of Radiology,Northern General Hospital, Sheffield, South Yorkshire S5 7AU, UK.

We present the case of a professional adolescent footballer who attended our clinic with ongoing instability symptoms and valgus knee deformity after conservative management of an medial collateral ligament injury. The patient was found to have sustained a contra-coup Salter Harris Type V injury to his lateral distal femur physis resulting in premature growth arrest and deformity. Salter Harris Type V injuries are rare, and often not diagnosed until growth has arrest has occurred due to lack of identifiable features on initial plain radiographs. Read More

Acta Orthop 2018 Feb 19;89(1):108-112. Epub 2017 Sep 19.

b Division of Orthopaedic Surgery , Severance Children's Hospital , Yonsei University College of Medicine , Seoul , Korea.

Background and purpose - The optimal treatment of displaced Salter-Harris (SH) II fractures of the distal tibia is controversial. We compared the outcomes of operative and nonoperative treatment of SH II distal tibial fractures with residual gap of >3 mm. Factors that may be associated with the incidence of premature physeal closure (PPC) were analyzed. Read More