A modified anterolateral swashbuckler approach for distal femoral fractures: description and outcomes.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Each author declares that he or she has no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangement etc.) that might pose a conflict of interest in connection with the submitted article. 7. EFORT Open Rev. 2022 Apr 25;7(4):264-273. doi: 10.1530/EOR-21-0110. Distal femoral fractures in children. Sepúlveda M(1)(2)(3), Téllez C(1)(2), Villablanca V(1)(2), Birrer E(1)(2). Author information: (1)Universidad Austral de Chile, Valdivia, Chile. (2)Hospital Base de Valdivia, Valdivia, Chile. (3)AO Foundation, PAEG Expert Group, Davos, Switzerland. The physis of the distal femur contributes to 70% of femoral growth and 37% of the total limb growth; therefore, physeal injury can lead to important alterations of axes and length. Distal metaphyseal corner-type fracture prior to walking is classically associated with child abuse. In children aged >10 years, sports-related fractures and car accidents are significant contributors. Imaging includes a two-plane radiographic study of the knee. It is recommended to obtain radiographs that include the entire femur to rule out concomitant injuries. In cases of high suspicion of distal metaphyseal fractures and no radiographic evidence, CT or MRI can show the existence of hidden fractures. Fractures with physeal involvement are conventionally classified according to the Salter-Harris classification, but the Peterson classification is also recommended as it includes special subgroups. Conservative and surgical management are valid alternatives for the treatment of these fractures. Choosing between both alternatives depends on factors related to the fracture type. As there is a high risk of permanent physeal damage, long-term follow-up is essential until skeletal maturity is complete. DOI: 10.1530/EOR-21-0110 PMCID: PMC9069856