[Fractures of and near the epiphysis in children. Part II: lower extremity].

Fractures of and near the epiphysis occur much less frequently in the lower extremities than in the upper extremities. The time required for consolidation of lower extremity fractures is twice as long as for fractures of the arm or hand. Irrespective of the longer time period for fracture healing, close attention must be paid to initial assessment of fractures regarding dislocations and deformities. Although pediatric fracture dislocations of the upper extremity can be tolerated to a great extent, the mechanisms for spontaneous compensation and even correction of posttraumatic deformities are very limited in pediatric fractures of the lower extremities. Additionally, deformities of the lower extremity skeleton result in a more severe functional impairment than would result from epiphyseal fractures of the arm or hand (with the exception of injuries to the elbow). Therefore, proper radiographic diagnostics with precise projection of the required planes are mandatory to accurately determine all further treatment options.