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Orthopaedics

Paediatric Distal Tibia and Fibula Fractures (AO Based)

Built from AO Surgery Reference: Orthopedic Trauma, Pediatric Trauma (AO Foundation)

What’s inside

4 sections · 104 slides

  1. 01

    Overview

    • Introduction
    • Ankle injuries in children
    • Physis, growth and remodeling
    • Growth of the distal tibial physis
    • Transitional fractures and physeal closure
    • Transitional fractures and physeal closure
    • Remodeling and acceptable alignment
    • Protecting the physis during fixation
    • Protecting the physis during fixation
    • Clinical and radiological assessment
    • History and symptoms
    • Physical examination
    • Imaging of distal tibial and fibular injury
    • Imaging of distal tibial and fibular injury
    • Imaging clues by injury type
    • Imaging clues by injury type
    • AO pediatric classification
    • Metaphyseal fractures: codes
    • Epiphyseal tibial fractures: SH I to IV
    • Epiphyseal tibial fractures: SH I to IV
    • Special epiphyseal patterns: E/5 to E/8
    • Fibular epiphyseal and ligament injuries
    • Fibular epiphyseal and ligament injuries
    • AO pediatric type tree: segment 43
    • Fracture types as drawn by AO
    • Fracture types as drawn by AO (cont.)
    • Fracture types as drawn by AO (cont.)
    • Metaphyseal fractures
    • Torus/buckle fractures
    • Simple complete metaphyseal fractures
    • Simple complete metaphyseal fractures
    • Treatment options: simple metaphyseal
    • Treatment options: simple metaphyseal (cont.)
    • Decision logic: metaphyseal fractures
    • Decision logic: metaphyseal fractures
    • Elastic nailing versus MIO bridge plating
    • Elastic nailing versus MIO bridge plating
    • Salter-Harris I and II of the distal tibia
    • Salter-Harris I fractures of the tibia
    • Salter-Harris II fractures of the tibia
    • Salter-Harris II fractures of the tibia
    • Treatment options: SH I and II
    • Treatment options: SH I and II (cont.)
    • Decision logic: SH II of the tibia
    • Decision logic: SH II of the tibia
    • Closed reduction and short leg cast
    • Closed reduction and short leg cast
    • Screw fixation of the Thurstan Holland piece
    • Screw fixation of the Thurstan Holland piece
    • K-wire constructs across the tibial physis
    • K-wire constructs across the tibial physis
    • Salter-Harris III and IV of the distal tibia
    • SH III and IV: definition and risks
    • Treatment options: SH III and IV
    • Treatment options: SH III and IV (cont.)
    • ORIF with screws for SH III and IV
    • ORIF with screws for SH III and IV
    • Transitional fractures: Tillaux, triplane
    • Tillaux fracture (43t-E/5.1)
    • Tillaux fracture (43t-E/5.1)
    • Triplane fracture (43t-E/6)
    • Triplane fracture (43t-E/6)
    • Two-part versus three/four-part triplane
    • Two-part versus three/four-part triplane
    • Treatment options: Tillaux and triplane
    • Treatment options: Tillaux and triplane
    • ORIF of a triplane fracture
    • ORIF of a triplane fracture
    • Other epiphyseal and fibular injuries
    • Medial malleolar avulsion (43t-E/7.1)
    • Medial malleolar avulsion (43t-E/7.1)
    • Osteochondral flake fractures (43t-E/8)
    • Osteochondral flake fractures (43t-E/8)
    • Distal fibular fractures in children
    • Treatment options: fibular SH I and II
    • Treatment options: fibular SH I and II

    76 slides

  2. 02

    Syndesmotic injuries

    • Syndesmotic injuries in children
    • Syndesmotic injuries in children
    • Sequence of a syndesmotic injury
    • Sequence of a syndesmotic injury
    • Syndesmotic screws versus suture-button
    • Syndesmotic screws versus suture-button

    6 slides

  3. 03

    Approaches and operative set-up

    • Approaches to the distal tibia and fibula
    • Approaches to the distal tibia and fibula
    • Safe zones for external fixator pins
    • Safe zones for external fixator pins

    4 slides

  4. 04

    Aftercare and complications

    • Aftercare timetable
    • Cast care and cast complications
    • Cast care and cast complications
    • Surveillance for growth disturbance
    • Surveillance for growth disturbance
    • Complications and their prevention
    • Take-home messages
    • References (1 of 7)
    • References (2 of 7)
    • References (3 of 7)
    • References (4 of 7)
    • References (5 of 7)
    • References (6 of 7)
    • References (7 of 7)
    • Join our WhatsApp groups

    15 slides