Distal Femoral Physeal Fractures and Peroneal Nerve Palsy: Outcome and Review of the Literature
John F. Sloboda, MD, Paul L. Benfanti, MD, John J. McGuigan, MD, and Edward D. Arrington, MD
MAJ Sloboda is Staff Orthopaedic Surgeon, Guthrie Ambulatory Clinic, Fort Drum, New York.
LTC(P) Benfanti is Staff Orthopaedic Surgeon, Madigan Army Medical Center, Fort Lewis, Washington.
MAJ McGuigan is Staff Orthopaedic Surgeon, Martin Army Community Hospital, Fort Benning, Georgia.
COL Arrington is Staff Orthopaedic Surgeon, Madigan Army Medical Center, Fort Lewis, Washington.
Abstract not available. Introduction provided instead.
Distal femoral physeal injuries commonly result in growth disturbance. Leg length discrepancy or angular deformities occur in approximately 40% to 50% of patients.1 The mechanism of the physeal injury usually involves a varus or valgus force with resultant medial or lateral displacement of the epiphysis.2 Injury to popliteal neurovascular structures has been less commonly associated with distal femoral physeal fractures. The mechanism of neurovascular injury is a hyperextension force with anterior displacement of the epiphysis resulting in traction injury.1 Peroneal nerve injury in association with distal femoral physeal injury has been described in 6 patients.3-7 Four of 6 patients had complete return of peroneal nerve function by 6 months.4,6,7 Two patients had described peroneal nerve injuries, though outcome was not reported.3,5 We describe an additional patient who sustained a distal femoral physeal fracture with concomitant peroneal nerve palsy.