Open AccessGrowth Plate Fractures of the Distal Femur
Author(s) -
Eric J. Wall,
Megan M. May
Publication year - 2012
Publication title -
journal of pediatric orthopaedics/journal of pediatric orthopedics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.318
H-Index - 96
eISSN - 1539-2570
pISSN - 0271-6798
DOI - 10.1097/bpo.0b013e3182587086
Subject(s) - medicine , malunion , femur , reduction (mathematics) , surgery , displacement (psychology) , internal fixation , nonunion , psychology , geometry , mathematics , psychotherapist
Growth plate fractures of the distal femur are challenging to treat, with complications that require a secondary surgery 40% to 60% of the time. These fractures often necessitate operative intervention, even in the youngest patients and even with minimal apparent displacement. Treatment varies with the Salter-Harris (SH) classification and with the extent of initial displacement, ranging from simple casting for nondisplaced SH I fractures to open reduction and internal fixation for almost all SH III and IV fractures. Poor outcomes have been associated with pediatric fracture care of SH III and IV in 29% to 32% of cases. There are many pitfalls that have to be avoided in the treatment of these fractures to prevent malunion, growth arrest, and posttraumatic arthritis.