Complicated distal femoral epiphyseolysis treated by Ilizarov method: Case report

Abstract

Introduction Injuries of the distal femur are rare in children; however, they are frequently associated with complications. They are almost always physeal, most frequently Salter-Harris type II epiphyseolysis. The treatment of such injuries is similar in all physeal injuries. It is intended to provide growth plate recovery by gentle reduction and stable fixation thus preventing secondary complications, and also to provide decompression of the segment to solve the compartment syndrome and recover the neurovascular structures. Case Outline A seven-year old boy presented with a right knee injury while sleigh riding. He was admitted three weeks following the injury with distal femoral epiphysiolysis associated with peroneal palsy. A day after admission to our Institute the reduction was performed using the Ilizarov device. Physical therapy was started immediately after surgery, as well as walking with weight bearing on the operated leg. Five months after surgery the patient was anatomically and functionally recovered. Conclusion The presented method is recommended in the treatment of such injuries because of several reasons; reposition is simple and complete, there is no need to open the fracture site, fixation is stable, the growth plate is preserved, there is no need for additional external immobilisation, and physical therapy involving walking with weight bearing on the operated leg may be started immediately after surgery. .