Abstract

MASQUIJO, J. Javier; LANFRANCHI, Lucas  and  ALLENDE, Victoria. Fracturas fisarias Salter-Harris VI de tobillo y pie. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2015, vol.80, n.2, pp.104-112. ISSN 1852-7434.

Background: Salter-Harris VI fractures (SHVI) are injuries in which part of the physis is missing. They are rare in children but potentially devastating. The aim of this study was to evaluate the mechanism of production, treatment, and functional outcomes of these injuries in the foot and ankle. Methods: All patients with foot and ankle SHVI injuries treated between January 2010 and January 2013 were retrospectively analyzed. Demographics, classification, mechanism of injury, type and number of associated injuries that required surgery were documented. Patients were assessed functionally with the AOFAS score and a radiological evaluation was performed to determine the viability of the physis, limb length discrepancies or angular deformities. Results: Five fractures in 4 patients were analyzed. The average age at injury was 7.5 years (range 6-10 years). Mean follow-up was 26.2 months (range 12-37 months). Three injuries occurred as a result of motorcycle accidents, and 2 in a car accident. All were associated with soft-tissue injuries, 75% had more than one injured bone and 50% had tendon lesions. Each patient required an average of 3.2 surgeries (range 2-5). The average AOFAS was 79.8 points (range 62-100). Radiographically, only 40% of the affected physis remained viable at last follow-up. Conclusions: SHVI fractures are associated with several injuries, require multiple surgeries and often result in premature growth arrest and some degree of disability. Prevention measures are required to avoid the exposure of children to this type of injury.

Keywords : Epiphysiolysis; Ankle; Children; Type VI physeal fractures; Physeal bar.

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