Imaging appearance of entrapped periosteum within a distal femoral Salter-Harris II fracture.

Abstract:

:Salter Harris II fractures of the distal femur are associated with a high incidence of complications, especially premature physeal closure. Many risk factors for this high rate of premature physeal closure have been proposed. More recently, entrapment of periosteum within the physis has been suggested as an additional predisposing factor for premature physeal closure. The radiographic diagnosis of entrapped soft tissues, including periosteum, can be suggested in the setting of a Salter-Harris II fracture when the fracture does not reduce and physeal widening >3 mm remains. We report a patient who sustained a distal femoral Salter-Harris II fracture following a valgus injury. The patient had persistent distal medial physeal widening >5 mm following attempted reduction. A subsequent MRI revealed a torn periosteum entrapped within the distal femoral physis. Following removal of the periosteum, the patient developed a leg length discrepancy which required physiodesis of the contralateral distal femur. We present this case to raise awareness of the importance of having a high index of suspicion of periosteal entrapment in the setting of Salter-Harris II fractures since most consider entrapped periosteum an indication for surgery.

journal_name

Skeletal Radiol

journal_title

Skeletal radiology

authors

Chen J,Abel MF,Fox MG

doi

10.1007/s00256-015-2201-x

subject

Has Abstract

pub_date

2015-10-01 00:00:00

pages

1547-51

issue

10

eissn

0364-2348

issn

1432-2161

journal_volume

44

pub_type

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