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Pediatric Distal Femur Fracture S72.453A 821.23

pediatric distal femur fracture xray

pediatric distal femur fracture xray

pediatric distal femur fracture ORIF

pediatric distal femur fracture ORIF

synonyms:

Pediatric Distal Femur Fracture ICD-10

 

A- initial encounter for closed fracture

B- initial encounter for open fracture type I or II

C- initial encounter for open fracture type IIIA, IIIB, or IIIC

D- subsequent encounter for closed fracture with routine healing

E- subsequent encounter for open fracture type I or II with routine healing

F- subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing

G- subsequent encounter for closed fracture with delayed healing

H- subsequent encounter for open fracture type I or II with delayed healing

J- subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing

K- subsequent encounter for closed fracture with nonunion

M- subsequent encounter for open fracture type I or II with nonunion

N- subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion

P- subsequent encounter for closed fracture with malunion

Q- subsequent encounter for open fracture type I or II with malunion

R- subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion

S- sequela

Pediatric Distal Femur Fracture ICD-9

  • 821.23 Supracondylar fracture of femur (closed)
  • 821.22 Fracture of lower end of femur (closed); epiphysis separation
  • 821.33 Supracondylar fracture of femur (open)

Pediatric Distal Femur Fracture Etiology / Epidemiology / Natural History

  • Generally result from direct trauma to the knee.

Pediatric Distal Femur Fracture Anatomy

  • The distal femur is especially susceptible to growth arrest after physeal fracture because of the projections of the physis, called mamillary processes. 

Pediatric Distal Femur Fracture Clinical Evaluation

  • ATLS resuscitation. These can be high enegery injuries, assessment should begin with the A,B,C's.
  • Obvious deformity of knee/thigh often with limb shortening
  • Document neurovascular exam before and after any treatment.

Pediatric Distal Femur Fracture Xray / Diagnositc Tests

  • A/P and lateral views of the knee.
  • CT: consider for fractures with intraarticular extention.

Pediatric Distal Femur Fracture Classification / Treatment

  • Generally Classified with Salter-Harris Classification
  • Discuss high potential for growth disturbance (physeal arrest) / leg length discrepancy with parents before any treatment. 525 of distal femoral growth plate fractures have form of growth disturbance. 22% of all distal femoral growth plate fractures develop a leg length discrepancy of greater than 1.5 cm. SH 1 fractures have lowest incidence of growth disturbance (36%), SH 4 fractures = 64%. (Basener CJ, J Orthop Trauma. 2009 Oct;23(9):663-7)
  • Non-displaced: long leg cast with frequent follow-up to ensure maintenance of reduction.
  • Displaced: CRPP vs ORIF.

Pediatric Distal Femur Fracture Associated Injuries / Differential Diagnosis

  • Anterior cruciate ligament injury
  • Posterior cruciate ligament injury

Pediatric Distal Femur Fracture Complications

Pediatric Distal Femur Fracture Follow-up Care

  • Follow every 6-12 months until skeletal maturity to assess for growth disturbance

Pediatric Distal Femur Fracture Review References

  • Rockwood and Greens
  • Basener CJ, Mehlman CT, DiPasquale TG. Growth disturbance after distal femoral growth plate fractures in children: a meta-analysis. J Orthop Trauma. 2009 Oct;23(9):663-7.
  • Lombardo SJ, Harvey JP Jr: Fractures of the distal femoral epiphyses: Factors influencing prognosis. A review of thirty-four cases.  J Bone Joint Surg 1977;59A:742-751.°

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