Distal Femur Physeal Fractures

Courtesy: Prof Nabil Ebraheim, University of Toledo, Ohio, USA

Distal femur physeal fractures in children

• There is 60 percentage physeal arrest following physeal injuries in the distal femur.
• The risk is higher in case where the initial fracture is displaced
• If MCL/LCL sprain in young patients, then consider the growth plate injury of the distal femur
• The thurston Holland fragment is a spike of metaphyseal bone in salter 2 distal femur fracture.
• if metaphyseal fragment is large then fix it with screws(parallel to physis)
• If fragment is small then do percutaneous pinning with smooth k wires.
• Distal femur grows at a rate of 9 mm/years
• Epiphysis of the distal femur is the first one to ossify &last one to fuse(contribute to 70perc growth of femur).
• Girls finish their growth at age of 14 yrs &boys at 16 yrs.
• Premature growth arrest will affect the metaphyseal part of the bone, not the epiphyseal part of the bone.