TITLE:
Surgical Management of Recent Traumatic Epiphyseal Fractures-Detachments of the Distal Femur at Gabriel Touré University Hospital
AUTHORS:
Mahamadou Diallo, Abdoul Kadri Moussa, Layes Toure, Kalifa Coulibaly, Mamadou Bassirou Traoré, Cheick Oumar Sanogo, Terna Traoré, Mamadou Diallo, Amadou Maiga, Adégné Togo
KEYWORDS:
Epiphyseal Detachment, Distal Femur, Treatment, Surgical
JOURNAL NAME:
Surgical Science,
Vol.14 No.2,
February
10,
2023
ABSTRACT: Traumatic epiphyseal detachment fractures of the
distal end of the femur are a rare lesion whose severity is linked to disabling
sequelae such as limb length inequality or most often axial deviation. In this
report, surgical treatment aims to reconstruct the anatomy of the distal femur,
to avoid secondary displacements and to allow early mobilization of the knee.
Surgery carried out mainly by the technique of plugging in or screwing, opened or better still closed,
can be a source of complications including migration of pins, infections, knee
stiffness, and growth disorders. The aim of this work was to describe their
epidemiological, anatomo-clinical, therapeutic and evolutionary aspects in the
Department of Orthopedics-Traumatology at the CHU Gabriel TOURE. It was a
retrospective study over 30 months from July 2019 to December 2021. In fact, it
concerned 42 patients with traumatic epiphyseal detachment of the distal femur
occurring within 21 days or less, on a healthy knee with cartilage fertile
treated surgically and followed in the department. However, the diagnosis of
traumatic epiphyseal detachment of the distal femur was retained thanks to the
clinical examination and supplemented by radiographic images of the knee from
the front and from the side. The treatment was surgical. The functional results
were evaluated according to the functional
criteria of the Eastern Orthopedic Traumatology Society (SOTEST). Forty-two patients included 32 boys and 10 girls of average age of 12 years with extremes of 8 years
and 16 years. The lesions were classified according to the Salter Harris
classification. We noted 24% type I (n = 10), type II 71% (n = 30), type III 2%
(n = 1), type IV 2% (n = 1). Union was achieved in all patients within an
average of 6 weeks with extremes of 4 and 12 weeks. The functional result was
considered good in 20% of cases and very good in 80%. Traumatic epiphyseal
detachment fractures of the distal end of the femur are a rare lesion whose
severity is linked to disabling sequelae such as limb length inequality or most
often axial deviation. Surgical treatment aims to reconstruct the anatomy of
the distal femur, to avoid secondary displacements and to allow early
mobilization of the knee.