Name of the Procedure:

Closed Treatment of Distal Femoral Epiphyseal Separation; Without Manipulation

Summary

This is a non-surgical procedure to treat a separation or fracture of the growth plate in the lower end of the femur (thigh bone) without manually realigning the bone. The treatment involves stabilizing the area using external supports such as casts or splints.

Purpose

This procedure addresses growth plate injuries in the distal femur, which can occur due to trauma or accidents. The goal is to allow the growth plate to heal properly, ensuring normal growth and development of the bone.

Indications

• Sudden pain and swelling in the knee area after a trauma
• Difficulty or inability to bear weight on the affected leg
• X-ray confirmation of a distal femoral epiphyseal separation
• Patients, typically children or adolescents, who have sustained such an injury

Preparation

• Patients may need to undergo X-rays or other imaging studies to confirm the diagnosis.
• Fasting is generally not required.
• Patients should inform their doctors of any medications they are taking.

Procedure Description

1. The patient is comfortably positioned.
2. A cast or splint is applied to the affected leg to immobilize the knee and femur.
3. No bone manipulation is performed; the area is stabilized externally.
4. The leg is usually elevated to reduce swelling.

Duration

The application of the cast or splint typically takes about 30-60 minutes.

Setting

This procedure can be performed in a hospital, outpatient clinic, or emergency room setting.

Personnel

• Orthopedic surgeon or pediatric orthopedist
• Nurses or medical assistants

Risks and Complications

• Potential for improper healing or misalignment
• Risk of stiffness in the knee joint
• Complications related to cast, such as skin irritation or pressure sores
• Rarely, growth disturbance in the affected leg

Benefits

• Non-invasive, avoiding the risks associated with surgery
• Allows for proper healing of the growth plate
• Quick application with minimal discomfort

Recovery

• Patients may need to wear the cast or splint for several weeks.
• Follow-up appointments are necessary to monitor healing.
• Gradual return to normal activities is recommended, with restrictions on high-impact activities until fully healed.

Alternatives

• Surgical intervention if the separation is severe or unstable
• Open reduction and internal fixation (ORIF) for complex cases
• Physical therapy post-recovery to restore function and strength

Patient Experience

• Typically, minimal pain during the procedure, though some discomfort from immobilization.
• Pain management includes over-the-counter pain medications.
• Adjustments in daily activities may be needed due to the immobilization of the leg.