Broken Ankles and Growth Plates

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Comments

  • Persuaded him to take the crutches into school.  The sheer crush at lesson change probably worried him slightly and the crutches will hopefully make people leave a wider gap so as not to shove him.

    Thanks for the reassurance re the crutches though.  I won't worry so much when he runs up the stairs now.

    So, do I ask the question 'is it perfectly aligned?' when we're in clinic on Friday?  

    What happens to those who do suffer a growth arrest?  Do they end up with one leg longer than the other?  Do they have to have reconstructive surgery?

    I feel a strange sense of relief now that the screw has been removed.  I didn't realise it was bothering me until it was no longer there if that makes any sense.  He never did walk properly while it was there and his walking appears much more normal now that it's been removed.  Apart from the one incident mentioned earlier in this thread when he accidentally put weight on the leg, he did completely immobilise it for the whole recovery period and so I'm hopeful of a positive outcome. 

  • Re perfectly aligned - I would assume that by opening the joint up, they were able to visualise the fracture and make sure it was aligned. So the question might be met with a shocked "of course", but then again, it's nice to be reassured.

    Re growth arrest. With this type of fracture, if growth arrest occurs it tends to be in the pattern of a "bar". This means that the growth plate stops growing along this bit, but the rest of the growth plate carries on, leading to malalignment of the joint surface. You can stop this happening either by trying to chop out the bar (tricky and not always successful), or by stopping the rest of the growth plate (easier but leaves you with some shortening). The resultant leg length discrepancy actually wouldn't be too great as the tibia grows more from the top end.

    BUT this is all HIGHLY unlikley to be needed as the most likely outcome BY FAR is normal healing, normal growth, and normal alignment!

    I do think it's worth asking questions and making sure you understand the Xrays in clinic, even if people seem a bit rushed.

    Glad you're happier about the crew - it's interesting that he's walking better,

  • Hi joddly

    Well, true to form, I forgot to ask all those questions.  I did ask about the Salter Harris though and apparently it was a type II.  The surgeon said it could have been manipulated without opening him up but when they attempted this under xray, they discovered something attached to some ligaments (bone I think?)  had actually broken away and they had to operate to sort that out.

    The x-ray yesterday looked absolutely fine and they don't want to see him again which I should think indicates that there are no concerns over growth.

    No contact sports for a few more weeks.  Walking is fine.  Cycling can begin soon (so long as he doesn't fall off .... not sure how to ensure that one - although he doesn't usually fall off).  I asked if he's allowed to run up and down stairs (because he does) and the answer was 'no'.  They just want the internal bit where the screw was to heal first which will take a few more weeks.

    Anyway, he seems fine and I am enormously relieved.  Thanks for the advice. 

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