Delayed treatment of a malreduced distal femoral epiphyseal plate fracture.
Fractures of the epiphyseal plate are considered rare when compared with the more prevalent injuries found in competitive sports, but the complications associated with this type of trauma are a major concern. The factors affecting the success or failure of healing include the severity of injury, patient age, and the type and expedience of treatment. This case study examines the clinical presentation and treatment of a 15-yr-old high school football player who sustained a displaced, distal femoral epiphyseal Salter II fracture. Primary treatment consisted of nonmanipulative, nonweight bearing knee immobilization. The treatment resulted in malunion, pain, decreased range of motion and physical deformity; therefore, the patient sought a second opinion. On physical exam, the displacement and rotational deformity of the fracture site were unacceptable. The fracture was treated 20 days post-injury via open reduction with internal fixation. On follow-up, the athlete demonstrated radiographic healing, normal physical exam, and no significant leg length discrepancy or deformity. The athlete successfully returned to full competitive sport activity.
Meyers
M C
MC
Texas Sports Science Institute, Sugar Land 77478.
Calvo
R D
RD
Sterling
J C
JC
Edelstein
D W
DW
D000293:Adolescent; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery*; D005538:Football / Q000293:injuries*; D005593:Fracture Fixation, Internal; D005596:Fractures, Closed / Q000000981:diagnostic imaging / Q000601:surgery*; D006132:Growth Plate / Q000000981:diagnostic imaging; D006801:Humans; D007718:Knee Injuries / Q000000981:diagnostic imaging / Q000601:surgery; D007719:Knee Joint / Q000000981:diagnostic imaging; D008297:Male; D011859:Radiography; D000072042:Salter-Harris Fractures; D013997:Time Factors