[Injuries of the upper end of the tibia in children. With the exclusion of fractures of the tibial shaft].

We review 58 cases of proximal tibial fractures in children. Their evolution and prognostic depend on the localisation. The intra epiphyseal fractures have a good prognostic if care is taken in reduction of the great deplacement fractures: as well as the epiphyseal plate fractures. The upper anterior tibial apophysis fractures have been reduced and screwed without any genu recurvatum sequellae. Severe growth disorder may follow proximal tibial contusions without parallelism regarding to them. Among the iatrogenic causes of these contusions, the trans-tibial pine traction may induce a genu recurvatum even far from the tibial tubercle: so we must avoid this method. The proximal metaphyseal tibial fractures and the valgus deformity following them represents a high difficult treatment. This deformity often recurs after osteotomy (with the risks of the operation). Anyway the tibia valga disappears spontaneously. Its evolution shows that it has a double origin: the fracture displacement then the medial overgrowth epiphyseal plate. The first cause can be treatment actually in order to limit the final valgus by closed reduction with anesthesia.