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<p>Periarticular physeal fractures around the knee are rare but are associated with a&#xa0;high risk of developing clinically relevant posttraumatic deformities. Even minor injuries may result in premature partial or complete physeal arrest. In cases of partial arrest, asymmetric continued growth of the unaffected physeal segments may lead to progressive angular deformities with or without clinically relevant limb length discrepancies. These secondary deformities frequently result in functional limitations and may predispose patients to the early development of knee osteoarthritis. This narrative review summarizes current knowledge on the epidemiology, pathophysiology, diagnostic evaluation, and treatment of premature posttraumatic physeal arrest around the knee. Key predictors of premature physeal arrest include the degree of fracture displacement, the energy of the injury, and the location and size of a&#xa0;transphyseal bone bridge. Clinically relevant growth disturbances typically become apparent within the first two&#xa0;years following trauma, underscoring the need for structured and long-term follow-up until skeletal maturity. Diagnostic evaluation is based on serial clinical assessments, full-length standing radiographs for alignment and limb length analysis, and adjunctive cross-sectional imaging to detect and define the extent of transphyseal bone bridges. Treatment strategies are guided by patient age, remaining growth potential, the severity of angular deformity and limb length discrepancy, and physeal integrity. Transphyseal bone bridges involving less than approximately one third to one half of the physeal area may be treated with resection aimed at physeal reactivation when sufficient growth remains; guided growth procedures may be used as adjuncts. In cases of extensive bone bridges and/or insufficient remaining growth, epiphysiodesis to prevent progression of deformity as well as acute or gradual osteotomy techniques for angular correction and limb length equalization are indicated. The overarching goal of all therapeutic interventions is the restoration of physiologic limb alignment, balanced limb length, and improved function.</p>

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Vorzeitiger posttraumatischer Verschluss kniegelenksnaher Wachstumsfugen

  • 期刊论文

  • 发表日期：

    2026年3月30日

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  • Andrea Laufer,
  • Björn Vogt

摘要

Periarticular physeal fractures around the knee are rare but are associated with a high risk of developing clinically relevant posttraumatic deformities. Even minor injuries may result in premature partial or complete physeal arrest. In cases of partial arrest, asymmetric continued growth of the unaffected physeal segments may lead to progressive angular deformities with or without clinically relevant limb length discrepancies. These secondary deformities frequently result in functional limitations and may predispose patients to the early development of knee osteoarthritis. This narrative review summarizes current knowledge on the epidemiology, pathophysiology, diagnostic evaluation, and treatment of premature posttraumatic physeal arrest around the knee. Key predictors of premature physeal arrest include the degree of fracture displacement, the energy of the injury, and the location and size of a transphyseal bone bridge. Clinically relevant growth disturbances typically become apparent within the first two years following trauma, underscoring the need for structured and long-term follow-up until skeletal maturity. Diagnostic evaluation is based on serial clinical assessments, full-length standing radiographs for alignment and limb length analysis, and adjunctive cross-sectional imaging to detect and define the extent of transphyseal bone bridges. Treatment strategies are guided by patient age, remaining growth potential, the severity of angular deformity and limb length discrepancy, and physeal integrity. Transphyseal bone bridges involving less than approximately one third to one half of the physeal area may be treated with resection aimed at physeal reactivation when sufficient growth remains; guided growth procedures may be used as adjuncts. In cases of extensive bone bridges and/or insufficient remaining growth, epiphysiodesis to prevent progression of deformity as well as acute or gradual osteotomy techniques for angular correction and limb length equalization are indicated. The overarching goal of all therapeutic interventions is the restoration of physiologic limb alignment, balanced limb length, and improved function.