Epiphyseal fractures and epiphysiolyses of the distal tibia

: In the years 1979, 1980 and 1981 a follow-up of 72 epiphyseal of the distal tibia was made. Half of the cases of epiphyseal fractures were treated conservatively, the other half operatively. Epiphysiolyses were treated conservatively without exception. In both groups disturbances of growth with partial closure of the growth plate and following malgrowth were found. The statistic evaluation of the case histories showed neither a sign of the cause nor a definite primary therapeutic influence on the disturbance of growth. On the basis of these results the classification effected to date of the epiphyseal traumas as well as their prognosis will be critically examined. From the clinicotherapeutic point of view epiphyseal fractures must be classified as joint lesions and epiphysiolyses as shaft fractures, even if the later are still lesions of the growth plate if considered from an anatomical point of view. On the basis of a clinically-orientated new classification of growth plate lesions, therapeutic principles are discussed.