The use of early flap coverage in severe open physeal fractures: a report of two cases.

Open physeal fractures associated with severe overlying soft tissue loss present significant challenges to the pediatric orthopaedic surgeon. In addition to providing adequate soft tissue coverage, preventing chronic infection, and achieving bony healing, surgical care should attempt to preserve the physis to maintain growth for the best long-term outcomes. Here we present two cases of open physeal disruptions with severe soft tissue loss. In each case, early use of vascularized flap coverage assisted in fracture healing and contributed to preservation of the physis and subsequent bony growth.