{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:38:40Z","timestamp":1787755120576,"version":"build-2784847793"},"reference-count":6,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n We performed open osteoclasis, soft-tissue release, and fracture fragment reduction and fixation to treat 10 cases of neglected physeal fractures of the distal aspect of the femur with severe deformity. To our knowledge, no specific surgical procedure for this problem has been reported in the literature.<\/jats:p>\n <\/jats:sec>\n \n Description:<\/jats:title>\n The procedure is typically performed through an extensile anterolateral approach. With use of an osteotome, the typically abundant fracture callus is disrupted and partially removed to recreate the original fracture line. Through periosteal dissection, an extensive musculoperiosteal detachment and release is achieved to facilitate fracture reduction while protecting the physis from further injury.<\/jats:p>\n <\/jats:sec>\n \n Alternatives:<\/jats:title>\n \n \n \n \n Knee rehabilitation in closed, nondisplaced or minimally displaced fractures\n 1<\/jats:sup>\n .\n <\/jats:p>\n <\/jats:list-item>\n \n \n Open callus osteoclasis in combination with a Z-shaped quadriceps tenoplasty, reduction, and plaster cast immobilization\n 2<\/jats:sup>\n .\n <\/jats:p>\n <\/jats:list-item>\n \n \n Open subperiosteal osteoclasis, reduction, and tibial traction\n 3<\/jats:sup>\n .\n <\/jats:p>\n <\/jats:list-item>\n \n \n Open callus osteoclasis, reduction, and condylar plating\n 4<\/jats:sup>\n .\n <\/jats:p>\n <\/jats:list-item>\n \n \n Sequestrectomy with preservation of a periosteal sleeve to treat osteomyelitis complicating an open fracture\n 1<\/jats:sup>\n .\n <\/jats:p>\n <\/jats:list-item>\n \n \n Transfemoral amputation to treat gas gangrene or vascular injury following severe open injury\n 1,5\u20137<\/jats:sup>\n .\n <\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Rationale:<\/jats:title>\n This procedure was developed in remote medical facilities where patients are often first seen >21 days after the original injury. By that time, closed reduction or standard open reduction and internal fixation techniques are no longer possible. After 6 months of fracture age, the procedure is inefficient.<\/jats:p>\n <\/jats:sec>\n \n Expected Outcomes:<\/jats:title>\n \n This procedure allows correction of limb malalignment and shortening while preserving the growth plate\n 1<\/jats:sup>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Important Tips:<\/jats:title>\n \n \n \n In some cases, hypertrophic fracture callus might be mistaken for the femoral diaphysis.<\/jats:p>\n <\/jats:list-item>\n \n An extensive musculoperiosteal release will facilitate reduction of the fracture fragments.<\/jats:p>\n <\/jats:list-item>\n \n The adequacy of reduction must be assessed in all 3 planes intraoperatively.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.2106\/jbjs.st.20.00003","type":"journal-article","created":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T14:01:35Z","timestamp":1614693695000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Reduction of Neglected Displaced Fractures of the Distal Femoral Physis"],"prefix":"10.2106","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3484-2268","authenticated-orcid":false,"given":"Malick","family":"Diallo","sequence":"first","affiliation":[{"name":"Universit\u00e9 Nazi Boni, Bobo-Dioulasso, Burkina Faso"},{"name":"CHU Sour\u00f4 Sanou, Bobo-Dioulasso, Burkina Faso"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3333-2661","authenticated-orcid":false,"given":"Massadiami","family":"Soulama","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Nazi Boni, Bobo-Dioulasso, Burkina Faso"},{"name":"CHU Sour\u00f4 Sanou, Bobo-Dioulasso, Burkina Faso"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adama","family":"Sidib\u00e9","sequence":"additional","affiliation":[{"name":"CHU Sour\u00f4 Sanou, Bobo-Dioulasso, Burkina Faso"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Souleymane","family":"Ou\u00e9draogo","sequence":"additional","affiliation":[{"name":"CHU Sour\u00f4 Sanou, Bobo-Dioulasso, Burkina Faso"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0525-5777","authenticated-orcid":false,"given":"Patrick Wendpouir\u00e9 Hamed","family":"Dakour\u00e9","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Nazi Boni, Bobo-Dioulasso, Burkina Faso"},{"name":"CHU Sour\u00f4 Sanou, Bobo-Dioulasso, Burkina Faso"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,1]]},"reference":[{"issue":"3","key":"bib1-20240731","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1007\/s00264-019-04450-7","article-title":"Management of neglected distal femur epiphyseal fracture-separation","volume":"44","author":"Diallo","year":"2020","journal-title":"Int Orthop."},{"issue":"1","key":"bib2-20240731","first-page":"199","article-title":"Old traumatic displacement of the distal femoral epiphysis: successful open reduction followed by epiphyseal arrest of the normal femur","volume":"18","author":"Levinthal","year":"1936","journal-title":"J Bone Joint Surg Am."},{"issue":"4","key":"bib3-20240731","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1097\/00000658-192904000-00011","article-title":"On the treatment of the separation of the lower epiphysis of the femur","volume":"89","author":"Gold","year":"1929","journal-title":"Ann Surg."},{"issue":"2","key":"bib4-20240731","first-page":"46","article-title":"Neglected Salter & Harris distal femoral fracture: reduction, osteotomy & fixation; a case report in Dakar","volume":"1","author":"San\u00e9","year":"2012","journal-title":"Orth Emerg Afr."},{"issue":"3","key":"bib5-20240731","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/S0030-5898(20)31927-1","article-title":"Deformity planning for frontal and sagittal plane corrective osteotomies","volume":"25","author":"Paley","year":"1994","journal-title":"Orthop Clin North Am."},{"issue":"458","key":"bib6-20240731","first-page":"12","article-title":"Separations of the epiphyses. 1867","volume":"458","author":"","year":"2007","journal-title":"Clin Orthop Relat Res."}],"container-title":["JBJS Essential Surgical Techniques"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.ST.20.00003","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:37:50Z","timestamp":1787751470000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.ST.20.00003"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1]]},"references-count":6,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.st.20.00003","relation":{},"ISSN":["2160-2204"],"issn-type":[{"value":"2160-2204","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1]]}}}