Ambulgekar Rajesh Kishanrao, Chhabda Gurneet Kaur
Department of Orthopaedics, Dr. Shankarrao Chavan Government Medical College, Nanded, Maharashtra, India.
J Orthop Case Rep. 2022 Oct;12(10):101-106. doi: 10.13107/jocr.2022.v12.i10.3386.
Physeal fractures are a rare entity to occur around the knee. However, they may prove to be dangerous when encountered due to their proximity to the popliteal artery and associated risk of premature physeal closure. A distal femur displaced, SH type I, physeal fracture is very uncommon and is most likely caused by high velocity trauma.
Here is a case of right sided distal femur physeal fracture dislocation in a 15-year-old boy having positional vascular compromise (popliteal vessel involvement) as a result of the fracture displacement. He was immediately planned for open reduction and fixation using multiple K wires due to limb threatening condition. We focus on the potential immediate and remote complications, the treatment modality and the functional outcome of the fracture.
Due to the potential risk of immediate limb-threatening complication due to vascular compromise, this kind of injury needs emergency fixation. Furthermore, long-term complications like growth disturbances have to be considered and prevented by early definitive treatment.
骨骺骨折在膝关节周围较为罕见。然而,由于其靠近腘动脉且存在骨骺过早闭合的相关风险,一旦发生可能会很危险。股骨远端移位的SH I型骨骺骨折非常少见,最有可能由高速创伤引起。
本文报告一例15岁男孩右侧股骨远端骨骺骨折脱位,因骨折移位导致体位性血管受损(累及腘血管)。由于肢体有受威胁情况,他立即被安排采用多根克氏针进行切开复位内固定。我们重点关注骨折的潜在近期和远期并发症、治疗方式及功能预后。
由于血管受损可能导致肢体立即面临威胁生命的并发症,此类损伤需要紧急固定。此外,必须考虑到生长紊乱等长期并发症,并通过早期确定性治疗加以预防。