Management of neglected distal femur epiphyseal fracture-separation

Diallo, Malick; Soulama, Massadiami; Hema, Alexander E.; Sidibé, Adama; Bandré, Emile; Dakouré, Patrick Wendpouiré Hamed

doi:10.1007/s00264-019-04450-7

Cited by 6 publications

(4 citation statements)

References 14 publications

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“…Pediatric DFPF are rare in the clinic and usually caused by direct violence. 5 , 6 , 16 Distal femur epiphysis has the most significant longitudinal growth potential in long bones, providing 35%–40% of the length of lower limbs. Pediatric DFPF might lead to an unequal length of lower limbs in adults.…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Percutaneous Leverage Reduction in the Treatment of Pediatric Salter–Harris IV and V Distal Femoral Physeal Fractures

Shu,

Ou,

Feng

et al. 2023

Orthopaedic Surgery

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ObjectiveDistal femoral physeal fractures (DFPF) are rare but severe injuries in children, and there is no consensus on treatments for Salter–Harris (S–H) IV and V type of DFPF yet. This study aimed to introduce a minimally invasive technique using percutaneous leverage reduction combined with Kirschner wires fixation in treating pediatric DFPF with S–H IV and V type of injury and evaluate the clinical results.MethodsFrom July 2008 to June 2018, the authors' institute (Union Hospital, Tongji Medical College) retrospectively reviewed all patients diagnosed with pediatric DFPF. They were divided into two groups according to received treatment: children in the minimally invasive technique group were treated with a minimally invasive percutaneous leverage reduction technique, and the traditional technique group included the other children who received the conventional open reduction with internal fixation (ORIF). The surgical and clinical results of the two groups were collected and analyzed. The independent sample t‐test analysis and the chi‐square test were applied to compare continuous and categorical variables.ResultsA total of 14 pediatric patients were recruited, including five females and nine males with DFEF. All eight patients in the minimally invasive technique group and four of the six patients in the ORIF group were treated successfully. One patient in the minimally invasive technique group opted for conservative treatment due to his good functional recovery, while the other two patients in the ORIF group needed further surgery because of the limb length discrepancy. There was a difference in surgery duration (p < 0.001), intraoperative fluoroscopy numbers (p = 0.006), intraoperative blood loss (p < 0.001), radiological union time (p = 0.003) and knee flexion angle (p < 0.001) between two groups. Patients in the minimally invasive technique group all received total knee society (KSS) scores, while the average scores in the ORIF group were lower (100.00 vs. 97.67).ConclusionThe minimally invasive technique is better than conventional ORIF in terms of surgery duration, intraoperative blood loss, radiological union time, knee flexion angle and average KSS score. This percutaneous leverage reduction technique might be a good alternative for treating S–H IV and V DFPF in children.

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Section: Discussionmentioning

confidence: 99%

Minimally Invasive Percutaneous Leverage Reduction in the Treatment of Pediatric Salter–Harris IV and V Distal Femoral Physeal Fractures

Shu,

Ou,

Feng

et al. 2023

Orthopaedic Surgery

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“…Numerous articles describe physeal lesions of the distal femur or proximal tibia [ [2] , [3] , [4] ], but their concomitant association is exceptional in the setting of a probable Salter V lesion [ 5 ]. It should be noted that after the management we recovered a LLLD of less than 20 mm (instead of 60 mm).…”

Section: Discussionmentioning

confidence: 99%

Management of neglected post-traumatic ipsilateral distal femoral and proximal tibial epiphysiodeses in adolescent: Case report

Schrijnemakers,

Lejeune,

Ciornohac

et al. 2023

Trauma Case Reports

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“…Osteoclastic techniques are often used in orthopedic surgery to treat bone deformities (i.e. osteogenesis imperfecta), especially in children where bone devascularization must be avoided during growth 23,24 . As shown in THREE LEVEL IMPACTION TECHNIQUE.…”

Section: Level #2 Mosaic Micro Osteotomies Of the Bony Cap Micro Oste...mentioning

confidence: 99%

A 3-Level Impaction Technique for Dorsal Reshaping and Reduction Without Dorsal Soft Tissue Envelope Dissection

Finocchi¹,

Vellone

Mattioli

et al. 2021

Aesthetic Surgery Journal

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Background Preservation Rhinoplasty (PR) techniques are continuously evolving in the last two years. Many variations of old-fashioned techniques have been proposed since Daniel coined this term in 2018. Objectives Authors want to describe indications for a new “three level impactions” technique allowing, in selected cases, a complete profile correction and dorsal reduction without the dorsal soft tissue envelope (STE) dissection. Methods Three hundred fifty primary closed rhinoplasty cases were retrospectively studied from January 2018 and October 2019. Age, sex, race and technical details, surgical time and complications have been registered. Ninety-five dorsums were reduced and shaped without dissecting the dorsal soft tissue envelope, combining a 1) swinging door septoplasty with low septal strip resection, 2) endonasal bony cap mosaic osteotomies, and 3) Let down or Push down operation (LDO/PDO). Results All patients showed a dramatic change in profile height and shape without neither dorsal STE dissection nor bony cartilage dorsal tissue resection. The average follow-up time was 14 months (range, 12-16 months). Conclusions In selected patients, dorsum can be preserved without soft tissue envelope dissection. By combining multiple endonasal maneuvers is possible to obtain a dramatic change without dissecting the soft tissue envelope and at the same time avoiding any dorsal tissue resection: mosaic osteotomies for DKA conversion from S to V shaped dorsum, LDO and low septal strip resection for impaction and quadrangular cartilage flap rotation for profile setting. It is a versatile technique in selected patients, which leads to fast recovery and natural results.

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Management of neglected distal femur epiphyseal fracture-separation

Cited by 6 publications

References 14 publications

Minimally Invasive Percutaneous Leverage Reduction in the Treatment of Pediatric Salter–Harris IV and V Distal Femoral Physeal Fractures

Minimally Invasive Percutaneous Leverage Reduction in the Treatment of Pediatric Salter–Harris IV and V Distal Femoral Physeal Fractures

Management of neglected post-traumatic ipsilateral distal femoral and proximal tibial epiphysiodeses in adolescent: Case report

A 3-Level Impaction Technique for Dorsal Reshaping and Reduction Without Dorsal Soft Tissue Envelope Dissection

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