Injuries of the distal femoral growth plate and epiphysis: should open ³

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reduction be performed?. Edmunds I. Nade S. Australian & New Zealand Journal of Surgery. 63(3):195-9, 1993 Mar. A retrospective study for the period 1978-91 revealed 33 patients with fractures involving the distal femoral growth plate and epiphysis. Treatment by closed reduction and casting resulted in a high rate of loss of position. Twenty-three of the patients were followed up for an average of 4.8 years. Salter-Harris type II fractures predominated. An analysis of Á this group showed that treatment by open reduction and internal fixation gave better results than closed reduction and casting, or percutaneous fixation. The authors advocate treating all displaced Salter-Harris type II, III and IV fractures by open reduction and internal fixation. If closed means are employed, extra care needs to be taken in short- and long-term follow up, and the patient and parents advised of the likelihood of loss of position, deformity and/or growth disturbance. *