Femoral Physeal Frx: Growth Plate Arrest


- Discussion:
    - physeal bone bridges
    - methods to estimate growth potential
    - anatomy of distal femoral physis
    - distal femoral physis grows roughly at a rate of 9 mm/year (girls finish growing at age 14) 
    - 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.

Predicting the Outcome of Physeal Fractures of the Distal Femur.   
              
Growth disturbance after distal femoral growth plate fractures in children: a meta-analysis.

The effect of percutaneous pin fixation in the treatment of distal femoral physeal fractures



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

Last updated by Data Trace Staff on Thursday, September 13, 2012 12:48 pm