[Surgical treatment of epiphysiolyses of the distal femur and the proximal tibia].

OBJECTIVE

Anatomic reduction and stabilization in case of dislocated injuries.

INDICATIONS: Dislocated epiphysiolyses types Harris-Salter I and II of the distal femur and the proximal tibia.

CONTRAINDICATIONS: General contraindications to anesthesia and surgical treatment as well as nondislocated injuries.

SURGICAL TECHNIQUE: After initial closed anatomic reduction, the fracture is stabilized with crossing Kirschner wires. If closed reduction is not successful, open reduction via a small medial or lateral incision becomes necessary. Selected injuries with a big metaphyseal wedge should be stabilized with screws, which are inserted parallel to the physis.

POSTOPERATIVE MANAGEMENT: Postoperative management of epiphysiolyses of the distal femur requires a pelvic leg cast for 4-6 weeks. In epiphysiolyses of the proximal tibia, a long-leg cast is adequate.

RESULTS

According to studies, complications after epiphysiolysis of the distal femur occur in 37-70%. Sound studies concerning epiphysiolysis of the proximal tibia do not exist.