[Surgical treatment of epiphysiolyses of the distal femur and the proximal tibia].
OBJECTIVE
Anatomic reduction and stabilization in case of dislocated injuries.


METHODS
Dislocated epiphysiolyses types Harris-Salter I and II of the distal femur and the proximal tibia.


METHODS
General contraindications to anesthesia and surgical treatment as well as nondislocated injuries.


METHODS
After initial closed anatomic reduction, the fracture is stabilized with crossing Kirschner wires. If closed reduction is not successful, open reduction via a small medial or lateral incision becomes necessary. Selected injuries with a big metaphyseal wedge should be stabilized with screws, which are inserted parallel to the physis.


METHODS
Postoperative management of epiphysiolyses of the distal femur requires a pelvic leg cast for 4-6 weeks. In epiphysiolyses of the proximal tibia, a long-leg cast is adequate.


RESULTS
According to studies, complications after epiphysiolysis of the distal femur occur in 37-70%. Sound studies concerning epiphysiolysis of the proximal tibia do not exist.
Oberle
Mike
M
Abteilung für Unfall- und Wiederherstellungschirurgie, Kindertraumatologie, St. Josefskrankenhaus Freiburg, Sautierstrasse 1, 79104, Freiburg, Germany. mike.oberle@rkk-sjk.de
Bonetta
Marco
M
Schlickewei
Wolfgang
W
D001863:Bone Screws; D001864:Bone Wires; D002648:Child; D004839:Epiphyses, Slipped / Q000601:surgery*; D005269:Femur / Q000601:surgery*; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery*; D013977:Tibia / Q000601:surgery*; D016896:Treatment Outcome