Clinico-Radiological Outcomes of Conservative versus Operative Treatment of Physeal Injuries

Physeal injuries are common in our day-to-day practice, with the utmost importance on early recognition so as to avoid complications such as premature physeal closure or limb length discrepancy. Physeal injuries are often missed, leading to poor outcomes. This study aims to evaluate the operative and nonoperative methods of treating physeal injuries. All pediatric patients who presented to the casualty ward with physeal injuries were enrolled, and regional distribution was done. Salter-Harris classification was used to classify the type of physeal injuries. Additional investigations such as computed tomography or magnetic resonance imaging were done where needed. A total of 117 patients were included in the study, out of which 73 were male and 44 were females. Type II Salter-Harris injuries were found to be the most common. Left-sided injuries were common as compared to right-side ones, out of which road traffic accidents was the most common mechanism of injury, followed by slips and falls. About 94.1% were closed injuries, while 5.98% were compounding injuries. Out of 117 patients, 73 were treated conservatively, while 44 were managed operatively. This study illustrated an overall similar success between the surgical and the conservative treatments for pediatric physeal injuries. Due to the higher complication rate reported in the conservative management group, the conservative treatment cannot be considered safer than the surgical treatment. With early recognition and effective treatment of physeal injuries, good results are expected even in intra-articular physeal injuries. Long-term follow-up is important to identify the development of physeal growth disturbances.