The Journal of Bone and Joint Surgery, Vol 59, Issue 6 742-751, Copyright © 1977 by Journal of Bone and Joint Surgery, Inc
Fractures of the distal femoral epiphyses. Factors influencing prognosis: a review of thirty-four cases
SJ Lombardo and JP Harvey
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.