The peroneal nerve is reported to be involved in about 3% of cases of distal femoral epiphyseal injuries. In our case, it was a Salter-Harris type III and type IV combination, and there was a high complication risk due to the existence of displacement, and relatives of the patient were throughly informed about this. Salter-Harris type I fractures had the lowest incidence of growth disturbance (36%), whereas Salter-Harris type IV fractures had the highest rate of growth disturbance at 64%. Complications included growth arrest, resulting in leg length discrepancy, permanent decreased range of motion, and angular deformity. Poor results correlated with severely displaced fractures, nonanatomic reduction, associated injuries, and open fractures. Salter-Harris type II fractures are the most common fracture type of the distal femoral physis. It helps in understanding the mechanism of injury and in predicting the likelihood of complications. The Salter-Harris classification continues to be the most widely used classification system for physeal fractures. Motor vehicle accidents and sports-related injuries are reported as the most common causes. Distal femoral epiphyseal fractures are uncommon but have a high incidence rate of complications and are responsible for 1–6% of all physeal injuries and less than 1% of fractures in children. Physeal closure and cessation of growth typically occurs at an age between 14 and 16 years in girls and between 16 and 18 years in boys. The distal femoral physis is the fastest growing growth plate in the human body at a rate of 1.0 cm per year, producing 70% of the longitudinal growth of the femur and 40% of the overall growth of the lower extremity. In his last control at the end of the one year, the knee regained full extension and 160° flexion. At the end of the six weeks, knee extension was full, flexion was 150°, and the patient started to walk with full weight. At the end of the three weeks, the splint was removed, a knee exercise program was implemented, and the patient was asked to walk on tiptoes for three weeks. The patient was followed up for three weeks with long leg splint in the postoperative period. Since the patient's growth continues, we ensured that no screw passes through the physis. Fixation was also applied to the medial condyle with one cannulated screw (Figures 2(c) and 2(d)). After a full anatomic reduction was achieved in our operation, the metaphyseal fragment was fixed to physis by two transverse cannulated screws. The fracture pattern was determined, and the patient underwent open reduction and internal fixation operation in emergency conditions. Postoperative anteroposterior and lateral radiograph of the left knee (c-d). Ĭomputed tomography of physeal (a) and metaphyseal (b) fracture. The treatment method may influence the final outcome. Both Salter-Harris classification and displacement of the fracture are significant predictors of the final outcome. ![]() Long-term complications like growth disturbance, with subsequent development of leg length discrepancy and/or angular deformities, are well reported to be seen in these certain types of injuries. They generally follow one of the patterns described in the Salter-Harris classification. Distal femoral physeal fractures are not common but have a high rate of complications and are responsible for 1–6% of all physeal injuries and less than 1% of fractures in children. The most common causes of injuries are traffic accidents and sport activities. ![]() Also, it is the biggest and the fastest growing epiphysis of the body, and it contributes to 40% of the lower extremity length. Distal femoral epiphysis comes up in the ninth week of the fetal life and is the only epiphysis with a visible ossific nucleus at birth.
0 Comments
Leave a Reply. |
Details
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |