Cozen fracture or phenomenon is the valgus angulation deformity of the tibia following a proximal tibial metaphyseal fracture in children.
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Epidemiology
This typically occurs as a late deformity in children aged 3-6 years.
Pathology
Etiology
Proposed causes include:
- non-recognized or under recognized valgus deformation at time of injury
- proximal tibial fractures in children typically involved valgus force resulting in laterally angulated distal tibia
- also inadequate reduction may play a role
- soft tissue interposition of periosteum and/or pes anserinus
- medial epiphyseal overgrowth stimulated by trauma
- greenstick fracture whereby medial aspect fractured but intact lateral aspect with subsequent bowing
Treatment and prognosis
These deformities usually self correct within 12-24 months. Younger children have better remodeling potential. Surgery can be considered if the patient is older with significant angulation or if there is failure to self correct a Cozen deformity.
History and etymology
Dr Lewis N Cozen (1911-2001), American orthopedic surgeon, first described this deformity in 1953 4.
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