Foot and Ankle International
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Wheeless' Textbook of Orthopaedics

Femoral Physeal Frx: Growth Plate Arrest


- Discussion:
    - physeal bone bridges
    - methods to estimate growth potential
    - anatomy of distal femoral physis
    - growth arrest, partial or complete, w/ progressive angulation &/or shortening ranges from 30% & 80% of pts;
          - shortening & angulation are more related to degree of initial displacement rather than accuracy of the reduction;
    - leg length discrepancy of > 2 cm may develop in 1/3 of pts;
    - incidence of growth arrest is high, even with satisfactory reduction;
    - angulation more than 5 deg may also develop in 1/3 of pts;
          - persistent angular deformity in coronal plane may not correct spontaneously with further growth;

- SH II:
    - if asymmetrical growth inhibition follows type II separation, portion of grwth plate underneath metaphyseal fx is spared;
    - if metaphyseal frag is medial, valgus deformity may ensue;
    - if metaphyseal frag is lateral, varus angulation may ensue;

- SH III:
    - look for vertical fracture line originating from the notch;
    - reduction may be unstable and require internal fixation;




Growth disturbances following distal femoral physeal fracture-separations.

Physeal arrest about the knee associated with non-physeal fractures in the lower extremity.




Original Text by Clifford R. Wheeless, III, MD.

Last updated by Clifford R. Wheeless, III, MD on Saturday, January 17, 2009 5:50 pm