Proximal tibial epiphyseal fracture in an infant.

Proximal tibial epiphyseal fractures are rare injuries occurring predominantly in older children and adolescents. They have not previously been reported in infants. The present case is that of a 7-month-old female infant with a displaced Salter-Harris type II fracture secondary to child abuse. This represents the youngest documented case of a proximal tibial epiphyseal fracture. Open reduction and internal fixation were performed because of failure to obtain an anatomic alignment by closed reduction. The anatomic reason for unsuccessful closed reduction intraoperatively was found to be an infolding of the pes anserinus and periosteum. Tibia valga occurred postoperatively because of asymmetrical physeal overgrowth and required corrective osteotomy.