Athletic / high impact exercises
First described in ballet dancers (Burrows 1956)
- tension side of bone / lateral side
- progression to complete fracture has been well documented in athletes
Point tenderness
- lateral aspect of tibia
Over time develop bony lump
Complex / high energy injuries
Management of soft tissues critical
- restore length with external fixation
- await for swelling to reduce
Restoration of alignment & joint surface imperative
Outcome guarded
Acceptable reduction
- varus / valgus < 5o
- anterior / posterior < 5o
- rotation 5o
- shortening 10 mm
Poor remodelling potential
- valgus
- apex posterior angulation / recurvatum
- rotational alignment does not remodel
- shortening / in 2-10 year old average overgrowth is only 5mm