Pediatric physeal slide-traction plate fixation for comminuted distal femur fractures in children.

Abstract

Operative stabilization without inhibiting epiphyseal growth of pediatric comminuted distal femur fractures presents specific challenges. The purpose of this study was to evaluate the clinical efficacy of pediatric physeal slide-traction plate (PPSP) fixation for comminuted distal femur fractures in children. We prospectively followed 16 children who were managed PPSP for the treatment of comminuted distal femur fractures between 2005 and 2009. There were 9 boys with a mean age of 10.4 years (range, 8 to 14 y) and 7 girls with a mean age of 9.9 years (range, 6 to 12 y). The mean follow-up was 36.4 months (range, 18 to 54 mo). There were no intraoperative complications related to this technology. All patients were healed, and the mean time was 10.1 weeks (range, 8 to 13 wk). X-ray analysis of the injured limb revealed that the PPSP could be extended as the femur grew, with a mean sliding length of 5.6 mm (range, 3 to 15 mm). All patients had excellent final outcomes, and had the plates removed with no noted complications except 1 patient who had valgus malalignment of 10 degrees at 6 months after the plate removal, which was of no clinical concern and required no intervention. These findings suggest that PPSP is a safe and effective treatment for children with comminuted distal femur fractures that can be extended as the epiphyseal plate grows with reliable internal fixation. Therapeutic level IV.