Features of treatment in children with fractures of the distal metaphysis of the shin bones: cases report

This case study discusses the treatment of distal methapyphiseal fractures of shin in children. The choice of this problem based on wide expansion of fractures and poor treatment results. Age of children ranges from 10 to 16 years. Examination was done with X-rays, computed tomography (CT), and ultrasound, especially in cases where damaged ligamentous apparatus was suspicious. The main method of treatment was surgical—osteosynthesis by pins, plates, and screws. In the rehabilitation period, the legs were immobilized by Plaster of Paris for 4–6 weeks. The first case demonstrated the probability of damage of the distal tibiofibularis ligaments and necessity of their reconstruction. In the management of the second case, the efficacy of CT scans in validation of the fracture is presented. The treatment of the teenager presented in the third case was based on biomechanical principles. In majority of cases, outcomes in the period of 6–8 weeks after trauma were good and satisfactory. In our opinion, diagnosis and treatment of distal methapyphiseal fractures of the shin in children must be different that was proved in the examination of bones and ligaments injuries. Creation of the special structure classification for understanding and effective treatment of these kinds of methepyphiseal fractures in children is believed to be necessar.