AI Article Synopsis
- The study examined intra-articular medial malleolar fractures in children, focusing on cases with poor outcomes due to malunion or damage to the growth plate.
- It found that even small malreductions (as little as 2 mm) can lead to unsatisfactory healing, challenging the idea that these fractures can remodel effectively over time.
- The researchers recommended that fractures should be surgically reduced and fixed if there is a step-off exceeding 1 mm to improve outcomes.
Article Abstract
We retrospectively analyzed cases of intra-articular medial malleolar fractures in skeletally-immature patients (Salter-Harris III and IV) with suboptimal outcomes at St. Louis Children's Hospital and Shriner's Hospital for Children. Common causes of poor outcome were fracture malunion or malreduction and physeal damage. Malreductions of only 2 mm does not appear to be tolerated and the concept of "remodeling" does not apply to these fracture patterns. Based on this study, we "recommend" fracture reduction and fixation if there is greater than 1 mm of fracture step-off..
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