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  • Title: [The mature twoplane and triplane fracture. Transitional fractures of the distal tibia combined with typical fracture patterns of adults].
    Author: Ruffing T, Muhm M, Winkler H.
    Journal: Unfallchirurg; 2011 Aug; 114(8):730-5. PubMed ID: 21528396.
    Abstract:
    Physiologic closure of the growth plate of the distal tibia occurs between the ages of 12 and 14 years in girls and 1 year later in boys. The closure of the tibial physis starts eccentrically at the ventrolateral zone of the medial malleolus extending dorsally and ends laterally. Therefore, the anterolateral zone is the last to ossify. The process of closure lasts about 18 months. During this period the growth plate loses its joint-protective function and transitional fractures may occur. The more the closure progresses the more lateral the location of the fracture. In addition to the typical transitional fractures, typical fracture patterns of adults in the ossified physis are possible due to a mature bone structure. We report two cases of transitional fractures combined with typical fracture patterns of adults due to a dorsomedial ossified physis in the distal tibia.
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