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. 2020 Mar;44(3):545-550.
doi: 10.1007/s00264-019-04450-7. Epub 2020 Jan 6.

Management of neglected distal femur epiphyseal fracture-separation

Malick Diallo  1 , Massadiami Soulama  2 , Alexander E Hema  2 , Adama Sidibé  2 , Emile Bandré  3 , Patrick W H Dakouré  2
Affiliations

Management of neglected distal femur epiphyseal fracture-separation

Malick Diallo et al. Int Orthop. 2020 Mar.

Abstract

Introduction: Neglected epiphyseal fracture-separations of the distal femur are rare. Still reported in developing countries, they lead to therapeutic issues. The objective of the study is to describe their characteristics and to propose treatment options.

Materials and methods: Ten years of ongoing study was held in our orthopedics department. All patients with a neglected epiphyseal fracture-separations of the distal femur after a knee trauma were included in the study. Pre-operative and post-operative data were collected and analyzed.

Results: A total of 13 cases of neglected traumatic epiphyseal fracture-separations of the distal femur were found among 8616 in-patients of the department. It was mainly boys (9M/4F) around 16 years that were received 14 weeks after knee trauma. Most of the injuries were an AO-type 33-E/2.1 (Simple Salter-Harris' type II) (n=12) distal femur malunion (n=10). Associated complications were cutaneous opening (n=7), superficial infection (n=4), deep infection (n=4). Fractures were management surgically (n=12) by an open osteoclasis procedure (n=9), debridement (n=7) and a thigh amputation (n=1). The outcome was better if an open osteoclasis procedure was early performed in closed distal femur mal-union with a complementary rehabilitation program.

Conclusion: Specialized trauma care facilities must be increased, and trauma education programs must be undertaken to avoid neglected epiphyseal fracture-separations of the distal femur in developing countries.

Keywords: Adolescent; Bobo-Dioulasso; Distal femur; Epiphyseal fracture-separation; Neglected.

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References

    1. Rathjen K, Birch J (2006) Physeal injuries and growth disturbances. In: Rockwood and Wilkins fractures in children, 6th edn. Lippincott Williams & Wilkins, Philadelphia, pp 102–104
    1. Shapiro F (2016) Epiphyseal growth plate fracture-separations. In: Pediatric Orthopedic Deformities, Volume 1. Springer, pp 505-612
    1. Foucher JT (2007) Separations of the epiphyses. 1867. Clin Orthop Relat Res 458:12-16. https://doi.org/10.1097/BLO.0b013e31803df190 - DOI
    1. Levinthal DH (1936) Old traumatic displacement of the distal femoral epiphysis: successful open reduction followed by epiphyseal arrest of the normal femur. J Bone Joint Surg 18(1):199–204
    1. Gold E (1929) On the treatment of the separation of the lower epiphysis of the femur. Ann Surg 89:577–579 - DOI

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