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Distal femoral fractures in children

Kimberly P Stone, MD, MS, MA
Klane White, MD
Section Editor
Susan B Torrey, MD
Deputy Editor
James F Wiley, II, MD, MPH


Distal femur fractures in pediatrics patients are discussed here. Hip fractures and femoral shaft fractures in children are discussed separately. (See "Hip fractures in children" and "Femoral shaft fractures in children".)


Distal femur fractures can be classified as metaphyseal fractures or physeal fractures.

Metaphyseal fractures — Transverse distal metaphyseal fractures (also called supracondylar femoral fractures) are the most common type of distal femur fracture in infants and young children (image 1) [1].

Physeal fractures — Distal physeal femur fractures occur more commonly in older children and adolescents. The Salter-Harris classification of physeal fractures is most often used (figure 1).

Salter-Harris type I – Salter-Harris type I fractures were thought to be an uncommon type of distal pediatric femur fracture in early studies, accounting for only about 7 percent of distal femur physeal fractures [2]. However, more recent studies suggest an incidence of between 21 to 25 percent [3-5]. Salter-Harris Type I fractures occur in vaginally delivered breech newborns, abused infants, and as a sports related injury in adolescents [6,7]. When there is no fracture displacement, initial plain radiographs may be negative which can make these injuries difficult to diagnose. (See 'Imaging' below.)

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Literature review current through: Dec 2017. | This topic last updated: Jul 31, 2017.
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