title: Nonunion of a distal femoral epiphyseal fracture-separation.
abstract: Distal femoral physeal fractures account for approximately 1% of all epiphyseal injuries. Complications include growth arrest and leg length discrepancy, malunion and deformity, and stiffness and knee instability. However, nonunion of such a fracture is exceedingly rare and has only been reported in patients with spinal dysraphism. We report a case of distal femoral physeal nonunion in a neurologically intact adolescent athlete. Initially, there was a delay in the diagnosis of this nondisplaced fracture, as the patient had normal roentgenograms. Additional imaging modalities (magnetic resonance imaging, stress radiographs) should be performed if there is a high index of suspicion of physeal injury when roentgenograms are normal.
authors.affiliation: Department of Orthopaedics, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: B A
authors.initials: BA
authors.lastname: Goldberg
authors.forename: D S
authors.initials: DS
authors.lastname: Mansfield
authors.forename: N A
authors.initials: NA
authors.lastname: Davino
mesh_terms: D001863:Bone Screws; D002648:Child; D003951:Diagnostic Errors; D004839:Epiphyses, Slipped / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D005264:Femoral Fractures / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D005538:Football / Q000293:injuries*; D005599:Fractures, Ununited / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011859:Radiography