Classification and Management of Epiphyseal Injury

Injuries involving epiphyseal plate is important because of special problems in diagnosis, management and tl later complications of serious disturbance of growth which may be predictable and preventable. We revieviewed 40 cases of epiphyseal injuried in 35 patients, managed at Department of Orthopaedic Surgery, Nation Medical Center from Jan. 1975 to Dec. 1981. The longest follow up was 4 ywars and 6 months and the shortest, year, the average being 2 years. The results were as follows: 1. The incidence of epiphyseal injuries was 35 patients in 211 patients of padiat.c fractures. 2. There were 29 males and 6 females. 3. The causes were falling down accident, slipping down accident, impinging injury, direct blow and traff accident in order 4. Roentgenographically, 23 cases were Type II of Salter & Harris classification, 8 cases were Type IV, cases were Type I, 2 cases were Type III, and 1 case was Type V. 5. Epiphyseal Injuries were found with order of decreasing frequency of distal radius, distal humerus, dist femur, phalanges, distal tibia, proximal humerus, distal fibula and proximal humerus. 6. The methods of treatment were C/R & 'cast immobilization, C/R & K-wire fixation, 0/R & K-wire fixation and C/R & screw fixation. 7. Complications were found in 2 cases of angular deformity in Type IV injury, 1 case of shortening in Type injury, and 1 case of angular deformity in Type V injury.