- 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