A retrospective analysis of 30 consecutive fractures of the distal fem
oral epiphyseal plate showed the best results occurred when fractures
were anatomically reduced and fixed with pins. No fractures with inter
nal fixation displaced, whereas 43% of fractures reduced without fixat
ion displaced during cast treatment. Complications were more frequent
in displaced than nondisplaced fractures. We were unable to demonstrat
e that gentle reduction under general anesthesia offered protection ag
ainst subsequent physeal arrest when compared with closed reduction in
the emergency room; however, reductions in the operating room were mo
re likely to be anatomic.