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MINERVA PEDIATRICA

A Journal on Pediatrics, Neonatology, Adolescent Medicine,
Child and Adolescent Psychiatry


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Minerva Pediatrica 2007 August;59(4):409-14

language: Italian

Complications of leg diaphyseal fracture in a pediatric patient: case report

Memeo A., Albisetti W., Cristini E., Briatico-Vangosa L., Viganò C.

1 Struttura Dipartimentale Ortopedia e Traumatologia Infantile Istituto Ortopedico G. Pini, Milano
2 Istituto di Scienze Ortopediche, Traumatologiche e Riabilitative, Università degli Studi di Milano, Milano


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Fractures in pediatric age have a prominent role when the growth plates are involved, which represent the point of least resistance of the skeleton in children. Traumas in these regions can, therefore, cause chondroepiphysary detachments and alterations of vascularisation which can result in growth anomalies. The aim of this paper is to stress how an early diagnosis combined with a correct therapeutic approach can avoid the onset of deformations and serious disabilities. The case of a 14-year-old boy with an evident deformation and functional impotence of the ankle joint associated with a 7.5 cm heterometry is descrkibed. Clinically limping, widespread muscular hypotrophy and a vast zone of trophic suffering of the skin were observed. Anamnesis revealed combined a tibia/fibula fracture due to a trauma caused by crush at the age of 4 years, treated in another hospital by the implant of an intramedullary nail. Upon removal of the nail, relatives referred a progressive deformation of the articulation. Radiographic view showed the presence of an antero-medial epiphysiodesis zone of the distal tibial physis. For this condition the patient underwent a double osteotomy associated with elongation of the same limb by way of Ilizarov external fixator which was removed after 7 months resulting in an evident correction of the axis and the length of the limb. The patient was kept under observation for a follow-up of 2 years with clinical and radiographic controls.

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