INJURIES OF THE DISTAL FEMORAL GROWTH PLATE AND EPIPHYSIS - SHOULD OPEN REDUCTION BE PERFORMED

A retrospective study for the period 1978-91 revealed 33 patients with fractures involving the distal femoral growth plate and epiphysis. Tr eatment by closed reduction and casting resulted in a high rate of los s of position. Twenty-three of the patients were followed up for an av erage of 4.8 years. Salter-Harris type II fractures predominated. An a nalysis of this group showed that treatment by open reduction and inte rnal fixation gave better results than closed reduction and casting, o r percutaneous fixation. The authors advocate treating all displaced S alter-Harris type II, III and IV fractures by open reduction and inter nal fixation. If closed means are employed, extra care needs to be tak en in short- and long-term follow up, and the patient and parents advi sed of the likelihood of loss of position, deformity and/or growth dis turbance.