Posttraumatic Tibiofibular Synostosis After Treatment of Distal Tibiofibular Fractures in XXXX .

@entity8213 @entity1 @entity4512 @entity174
INTRODUCTION: Posttraumatic pediatric distal tibiofibular @entity8213 is a rare complication following @entity174 . This is a retrospective, multicenter case series of @entity8213 of distal tibiofibular @entity174 in @entity1 . The purpose was to evaluate the incidence and pattern of posttraumatic distal tibiofibular @entity8213 in @entity1 . METHODS: Of the 604 pediatric distal tibiofibular @entity174 , 20 @entity1 (3.3%) with @entity8213 after treatment of distal tibiofibular @entity174 were identified at 3 tertiary referral centers. There were 12 @entity1 and 8 @entity1 , with a mean age of 8.4  2.0 years (range, 3.7 to 11.5 y) at the time of injury. Medical records were reviewed, and serial radiographs were analyzed to determine @entity174 configuration, pattern of @entity8213 , and changes in the relative positions of the proximal and distal tibial and fibular physes and in the alignment of the ankle. RESULTS: The time from the occurrence of @entity174 until the recognition of the @entity8213 ranged from 2 to 6 months (mean, 2.8 mo). The most common @entity174 configuration was oblique @entity174 combined with comminuted fibular @entity174 . There were 12 focal types and 8 extensive types. The proximal tibiofibular distance was decreased in 13 @entity1 . Proximal migration of the distal fibular physis developed in all cases. Five @entity1 exhibited ankle valgus of 10 degrees or greater with moderate or severe distal fibular shortening. Eight @entity1 were symptomatic after @entity8213 and 12 @entity1 were asymptomatic. CONCLUSIONS: We identified 2 patterns of @entity8213 after the treatment of pediatric distal tibiofibular @entity174 : focal and extensive. The focal type was more prevalent than the extensive type, which was more likely to occur due to high-energy injury. When a tibiofibular cross-union develops, it creates growth abnormalities that warrant observation and potential treatment, as it may lead to progressive @entity4512 . LEVEL OF EVIDENCE: Level IV.
