Distal Femoral Physeal Fracture

Question 1

What pediatric fracture has a high incidence of growth arrest?

Answer 1

Distal femora physeal fx; most commonly presents as a SH II fracture

Question 2

What factors increase incidence of poor outcomes in distal femoral physeal fractures?

Answer 2

1) SH type
2) Violation of physis with hardware
3) Articular incongruity

Question 3

What is the treatment for non-displaced distal femoral physeal fractures?

Answer 3

Long leg cast

Question 4

What is the treatment for displaced distal femoral physeal fractures?

Answer 4

SH I and II: CRPP followed by casting

SH III and IV: ORIF

Question 5

When is a physeal bar excision an appropriate treatment for partial growth arrest of a distal femoral physeal fracture?

Answer 5

When bar is less than 50% of physis and 2 years of growth remaining.
Deformities that are >20° will require a corrective osteotomy