Date: Wed, 11 Feb 2004 20:52:48 -0500
Subject: Salter 2 proximal tibia fx
From: Charles M. Blitzer
15 yo boy w/ displaced Salter 2 prox tibia. Had good closed reduction but recurrent deformity in cast.
I'd appreciate thoughts re: fixation in situation w/ open physis. Do screws across physis cause concern for growth/deformity.
Date: Fri, 13 Feb 2004 16:39:20 -0600
From: Steven Rabin
Can you send better quality images? I can't really define the fracture from what you sent. In general, screws should not cross the physis, but with a salter II, the metaphyseal fracture can usually be fixed with a screw parallel to the physis. Smooth pins can generally cross a physis, but not threaded pins (or threaded screws...and certainly don't compress across the physis with a lag screw...)