{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T23:30:11Z","timestamp":1794439811860,"version":"4.9.1"},"reference-count":19,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2017,10,1]],"date-time":"2017-10-01T00:00:00Z","timestamp":1506816000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Journal of Sports Medicine"],"published-print":{"date-parts":[[2017,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Intra-articular physeal fractures of the distal femur are an uncommon injury pattern, with only a few small case series reported in the literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To pool patients from 3 high-volume pediatric centers to better understand this injury pattern, to determine outcomes of surgical treatment, and to assess risk factors for complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Case series; Level of evidence, 4.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A multicenter retrospective review of all patients presenting with an intra-articular physeal fracture between 2006 and 2016 was performed. Patient demographic and injury data, surgical data, and postoperative outcomes were documented. Radiographs were evaluated for fracture classification (Salter-Harris), location, and displacement. Differences between patients with and without complications were compared by use of analysis of variance or chi-square tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 49 patients, with a mean age of 13.5 years (range, 7-17 years), met the inclusion criteria. The majority of fractures were Salter-Harris type III fractures (84%) involving the medial femoral condyle (88%). Football was responsible for 50% of the injuries. The initial diagnosis was missed in 39% of cases, and advanced imaging showed greater mean displacement (6 mm) compared with radiographs (3 mm). All patients underwent surgery and returned to sport with \u201cgood to excellent\u201d results after 2 years. Complications were more common in patients with wide-open growth plates, patients with fractures involving the lateral femoral condyle, and patients who were casted ( P &lt; .05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Clinicians evaluating skeletally immature athletes (particularly football players) with acute knee injuries should maintain a high index of suspicion for an intra-articular physeal fracture. These fractures are frequently missed, and advanced imaging may be required to establish the diagnosis. Leg-length discrepancies and angular deformities are not uncommon, and patients should be monitored closely. Surgical outcomes are good when fractures are identified, with high rates of return to sport.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2325967117731567","type":"journal-article","created":{"date-parts":[[2017,10,10]],"date-time":"2017-10-10T04:00:26Z","timestamp":1507608026000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":17,"title":["Intra-articular Physeal Fractures of the Distal Femur: A Frequently Missed Diagnosis in Adolescent Athletes"],"prefix":"10.1177","volume":"5","author":[{"given":"Andrew T.","family":"Pennock","sequence":"first","affiliation":[{"name":"Rady Children\u2019s Hospital, San Diego, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry B.","family":"Ellis","sequence":"additional","affiliation":[{"name":"Sports Medicine Center, Texas Scottish Rite Hospital, Dallas, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel C.","family":"Willimon","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Children\u2019s Healthcare of Atlanta, Atlanta, Georgia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Wyatt","sequence":"additional","affiliation":[{"name":"Sports Medicine Center, Texas Scottish Rite Hospital, Dallas, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel E.","family":"Broida","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Children\u2019s Healthcare of Atlanta, Atlanta, Georgia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Morgan","family":"Dennis","sequence":"additional","affiliation":[{"name":"Rady Children\u2019s Hospital, San Diego, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracey","family":"Bastrom","sequence":"additional","affiliation":[{"name":"Rady Children\u2019s Hospital, San Diego, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,10,10]]},"reference":[{"key":"bibr1-2325967117731567","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0b013e3182648d45"},{"key":"bibr2-2325967117731567","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0b013e3180dca0e5"},{"key":"bibr3-2325967117731567","doi-asserted-by":"publisher","DOI":"10.1097\/00007611-196206000-00001"},{"key":"bibr4-2325967117731567","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198307000-00029"},{"key":"bibr5-2325967117731567","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1007\/BF00266068","volume":"4","author":"Czitrom AA","year":"1981","journal-title":"Int Orthop"},{"key":"bibr6-2325967117731567","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.1993.tb00517.x"},{"key":"bibr7-2325967117731567","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-1383(01)00109-7"},{"key":"bibr8-2325967117731567","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0b013e3181e4f55b"},{"key":"bibr9-2325967117731567","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0b013e31829d55bf"},{"key":"bibr10-2325967117731567","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-197759060-00005"},{"key":"bibr11-2325967117731567","doi-asserted-by":"publisher","DOI":"10.1177\/0363546507311099"},{"key":"bibr12-2325967117731567","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-199407000-00002"},{"key":"bibr13-2325967117731567","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199202000-00041"},{"key":"bibr14-2325967117731567","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198365070-00002"},{"key":"bibr15-2325967117731567","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.121.1.69"},{"key":"bibr16-2325967117731567","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-196345030-00019"},{"issue":"2","key":"bibr17-2325967117731567","first-page":"72","volume":"15","author":"Sasaki T","year":"2002","journal-title":"J Knee Surg"},{"key":"bibr18-2325967117731567","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-199507000-00013"},{"key":"bibr19-2325967117731567","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198163040-00008"}],"container-title":["Orthopaedic Journal of Sports Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2325967117731567","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2325967117731567","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2325967117731567","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T23:33:08Z","timestamp":1777591988000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/2325967117731567"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,10,1]]},"references-count":19,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2017,10,1]]}},"alternative-id":["10.1177\/2325967117731567"],"URL":"https:\/\/doi.org\/10.1177\/2325967117731567","relation":{},"ISSN":["2325-9671","2325-9671"],"issn-type":[{"value":"2325-9671","type":"print"},{"value":"2325-9671","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,10,1]]},"article-number":"2325967117731567"}}