Diaphyseal - Fracture : Salter Type V Injury Revisit

A 17-year old boy with a history of a right femoral shaft fracture, fixed with a reamed intramedullary nail four years earlier, presented with a 15° genu recurvatum deformity, presumably due to premature closure of the anterior proximal tibial physeal plate following a Salter type V injury. He was treated with a supra-tubercular anterior opening wedge osteotomy, fixed with two Puddu plates and grafted with bone matrix substitute. The patient went on to unite without complication, but came back to clinic six years later with anterior knee pain and patella infera. The paper discusses genu recurvatum after growth plate arrest and the various techniques to address the problem. Moving the tibial tubercle by including it in the osteotomy should be considered to avoid the complication of patella infera.