Fracture separation of the distal epiphysis of the tibia constitutes 10% of all epiphyseal fractures occurring in children. We studied 120 cases, which were treated stationary at our Department over the 10 year period between 1990 – 2000. The ratio between boys and girls was 2:1. The average age was 12,5 years (8–15 years). In 96 cases (80%) the injury occurred after a fall on the playground, in 12 cases (10%) after a roadtraffic accident and in 12 cases (10%) after a fall from a height. The average follow up is 7,2 years (2–12 years). According to the Salter-Harris classification 6 cases (5%) were Salter I, 90 cases (80%) were Salter II, 9 cases (9%) were Salter III and 6 cases (5%) were Salter IV. In all cases a closed reduction under general anaesthesia was attempted. If the reduction was succesful a whole leg plaster was applied. If the reduction was unstable a transcutaneous stabilisation or open reduction and internal fixation was performed. If a reduction could not be acchieved open reduction and internal fixation (ORIF) was performed using Kirschner wires or screws. Closed reduction was performed in 94 cases (78,34%), transcutaneous osteosynthesis in 2 cases (1,66%) and ORIF in 24 cases (20%).

We conclude that sports and for instance football is the main cause, where this injury occurs. The treatment is mainly conservative and complications are rare, when anatomical reduction is acchieved. The most common complication is angulation resulting from the injury at the epiphyseal plate, for instance varus angulation, which occurs from supination injuries mainly of Salter-Harris type III and IV.

Fracture of the lateral humeral condyle accounts for approximately 15% of all elbow fractures in children.

We studied 68 fractures of the lateral humeral condyle, which were treated surgically over a period of six years during 1994 to 2000. There were 49 boys and 19 girls. The average age was 6,5 years (2,5 – 13 years). All cases were treated with open reduction and internal fixation with two divergent K-wires for safer stabilisation of the fracture. Subsequently a cast was applied for 4–6 weeks to the radiological union of the fracture, where the K-wires were removed.

The patients were evaluated with clinical and radiological criteria. Sixty-five cases were classified as Milch type II fractures and three were Milch type I fractures. According to the Jacob classification, which records the degree of displacement, 23 cases were type II fractures and 45 cases were type III fractures. The mean follow up was 4 years (2–8 years). Analysis of the postoperative radiographs showed that radiological union was achieved in all cases. The mean time to radiological union of the fracture was 4,5 weeks (3–8 weeks). At latest follow up we observed abnormalities of the shape of the distal humerus due to overgrowth of the lateral humeral condyle in 40% of the cases. In 4 patients we observed pseudocubitus varus due to overgrowth of the lateral humeral condyle and in 3 patients we observed mild cubitus varus (< 5°). Clinically in all cases there was painless free movement of the elbow.

We conclude that satisfactory anatomical reduction of the fracture gives good clinical results. The radiological abnormalities observed seem not to play an important role in the final result.