Fractures of the distal femoral epiphyses. Factors influencing prognosis: a review of thirty-four cases.

In a review of thirty-four fractures through the distal femoral epiphyseal plate followed for an average of four years, limb-length discrepancy of 2.0 centimeters or more (measured roentgenographically) occurred in 36% and varus or valgus deformity measured as a difference of 5 degrees or more between the involved and uninvolved extremities occurred in 33%. Reconstructive procedures (osteotomy, epiphyseodesis, or both) were required in 20%. Limitation of knee motion (eleven patients), ligament laxity (eight patients), and quadriceps atrophy (five patients) were also observed. Prognoses made on the basis of the Salter-Harris classification alone were not reliable. The development of deformity appears to be related to the degree of initial displacement of the fracture, the exactness of the reduction, and the type of fracture.