Abstract
Distal femoral physeal fractures are not common but have a high rate of complications. They generally follow one of the patterns described in the Salter-Harris classification. We present a case of combination of Salter-Harris type III and type IV injury. Our case was a 15-year-old boy who had a motor vehicle accident. There was swelling, ecchymosis, severe pain, and valgus deformity, because of medial proximal fracture fragment, on the left knee. We deemed that Salter-Harris type III and type IV combination fracture in our case has not been previously reported. We prepared this paper in consideration of its contribution to the literature.
Highlights
Distal femoral epiphysis comes up in the ninth week of the fetal life and is the only epiphysis with a visible ossific nucleus at birth
After a full anatomic reduction was achieved in our operation, the metaphyseal fragment was fixed to physis by two transverse cannulated screws
We consider that high complication risks of distal femoral physeal fractures should be told to relatives of the patient
Summary
Distal femoral epiphysis comes up in the ninth week of the fetal life and is the only epiphysis with a visible ossific nucleus at birth. Distal femoral physeal fractures are not common but have a high rate of complications [3] and are responsible for 1–6% of all physeal injuries and less than 1% of fractures in children [4] They generally follow one of the patterns described in the SalterHarris classification [5]. Long-term complications like growth disturbance, with subsequent development of leg length discrepancy and/or angular deformities, are well reported to be seen in these certain types of injuries [3]. Both Salter-Harris classification and displacement of the fracture are significant predictors of the final outcome. The treatment method may influence the final outcome [3]
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