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This patient sustained a distal femoral physeal fracture. The risk of physeal arrest with possible growth disturbance and deformity is approximately 30-50%. Distal femoral physeal fractures are common fractures in the pediatric population that result from direct trauma. Diagnosis is confirmed with plain radiographs of the femur and knee. Treatment is usually operative with reduction and fixation.. These fractures are at high risk for the development of future growth arrest. Youg et al. reviewed physeal fractures of the distal femur. They reported that these injuries tend to have a worse prognosis than similar injuries in other locations due to an increased risk for both vascular injury and growth arrest. Garrett et al. reviewed distal femoral physeal fractures in children. They reported that an incidence of physeal arrest, occurring in a mean of 40% of cases. They noted that formation of a physeal bar occurred in 22% of patients, with the rate rising to 31% in patients with high-energy injuries compared with 5% in those with low-energy injuries. They concluded that there was a significant trend for physeal arrest according to increasing severity using the Salter-Harris classification and that percutaneous smooth pins across the physis were not statistically associated with growth arrest. Figure A is the radiograph of the knee demonstrating a distal femoral physeal fracture Incorrect Anwers: Answers 1,3-5: The rate of physeal arrest that often leads to growth disturbance and deformity is approximately 30-50% after a distal femoral physeal fracture
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