Poor outcomes in 29-32% of SH III and IV distal femoral fractures
Physeal gapping studies
Physeal gap > 3 mm associated with entrapped periosteum
Entrapped periosteum increases risk of premature physeal closure
Juvenile Tillaux and transitional fracture references
Juvenile Tillaux fracture characterization
SH III of anterolateral distal tibial epiphysis during transitional physeal closure
Operative threshold articular step-off >= 2 mm
CT essential to distinguish from triplane fracture
Transitional fracture epidemiology
Distal tibial physis closes asymmetrically over 18 months from ages 12-16
Window of vulnerability creates Tillaux and triplane fracture patterns
Coding and classification standards
ICD-10 S89.03 — Salter-Harris Type III physeal fracture of lower end of tibia
ICD-10 S72.43 — Salter-Harris Type III physeal fracture of lower end of femur
ICD-10 S82.15 — Salter-Harris Type III physeal fracture of upper end of tibia
SNOMED CT physeal fracture concepts
Salter-Harris Type III fracture of growth plate
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