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Initial angular deformity and its recovery of the proximal tibial metaphyseal fracture according to the cause: trampoline-related injury versus other injuries

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Abstract Purpose This study investigated the initial angular deformity of proximal tibial metaphyseal fracture in children and its recovery during follow-up according to the cause of injury. Methods Prospective data… Click to show full abstract

Abstract Purpose This study investigated the initial angular deformity of proximal tibial metaphyseal fracture in children and its recovery during follow-up according to the cause of injury. Methods Prospective data about the patients with a proximal tibial metaphyseal fracture at the age less than six years and available follow-up data at two years post-trauma were retrospectively reviewed. They were grouped into trampoline-related injuries (TRI) and non-TRI groups based on the cause of injury. Proximal tibial valgus and recurvatum angles were measured to assess angular deformity on the coronal and sagittal planes, respectively. Results A total of 47 patients (33 TRI and 14 non-TRI) were included. Initially, the valgus angles were -1.5° in TRI and 1.6° in non-TRI groups (p < 0.001) and the recurvatum angles were 7.8° in TRI and 4.1° in non-TRI groups (p = 0.048). After two-year follow-up, the valgus angles were 0.2° in TRI and 0.9° in non-TRI groups (p = 0.070), and the recurvatum angles were 6.5° in TRI and 2.3° in non-TRI groups (p = 0.001). Conclusion For children with a proximal tibial metaphyseal fracture, the initial coronal deformity was different according to the injury cause (varus in TRI whereas valgus in non-TRI). Although there was a near complete recovery after approximately two years of follow-up in the coronal deformities, the sagittal deformity (genu recurvatum) seems to recover incompletely or tardily, especially for those caused by TRI. Level of Evidence III

Keywords: proximal tibial; non tri; tibial metaphyseal; metaphyseal fracture; deformity

Journal Title: Journal of Children's Orthopaedics
Year Published: 2020

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