Traumatic epiphyseal arrest from bridge of bone. A and B, Anteroposterior radiographs and tomogram of lesion resulting from trauma to medial aspect of the distal tibial epiphysis. C-E, Steps in operative technique of Ingram for excision of bony bar and wedge osteotomy of distal tibia (see text). F, Radiograph showing correction of deformity and defect at bony bridge site. (C to F from Canale ST, Harper MC: Biotrigonometric analysis and practical applications of osteotomies of tibia in children, Instr Course Lect 30:85–101, 1981.) SEE TECHNIQUES 32.25 AND 32.26.