Fractures of the Proximal Tibial Metaphysis in Children

Abstract

Twenty-five cases of fractures of the proximal tibial metaphysis in children are reported. They are divided into three groups: torus fractures, greenstick fractures, and complete fractures. Genu valgum appeared in 12 cases of complete or greenstick fractures. Eleven deformities deteriorated progressively in the year following trauma. Three of these were spontaneously compensated for by growth at the inferior epiphyseal plate. Four corrective osteotomies were performed in the series, but this procedure is not recommended because of the significant risk of recurrence and the possibility of compartment syndrome, even with associated fibular osteotomy. A persistent valgus deformity can be corrected during puberty, if necessary, by a medial tibial epiphysiodesis.