case_images: PMC11799265_01
case_images: MRI scan of the patient's right knee. (A) Epiphyseolysis of the distal femur in the sagittal view. Because the epiphyseal scar is not crossed and the fracture line is along the epiphyseal scar, this is classified as a Salter-Harris type 1 fracture. (B) Axial view of the right knee. The femoral condyle appears to be dislocated ventromedially from the femoral metaphysis.
case_images: fped-12-1425358-g001.jpg
case_images: PMC11799265_01_fped-12-1425358-g001.jpg
case_images: F1
case_images: A magnetic resonance imaging (MRI) scan was performed for further evaluation and to rule out any inflammatory processes (Figure 1). In this case, we decided on a Kapandji maneuver via a medioventral approach because the distal fragment presented as one block (Figure 1), was still rotated medioventrally after manual repositioning, and was well accessible for percutaneous K-wire positioning.
case_images: Intraoperative radiograph of the right knee with K-wires inserted. (A) Sagittal view of the intraoperative radiograph. The tibia is being held in traction. (B) Coronal view after the insertion of four 2.2-mm K-wires. (C) Sagittal view. The epiphysis is correctly aligned axially.
case_images: fped-12-1425358-g002.jpg
case_images: PMC11799265_01_fped-12-1425358-g002.jpg
case_images: F2
case_images: To further stabilize the relatively high-volume femoral metaphysis, two additional K-wires were inserted parallel to the two already in place (Figure 2).
case_images: Follow-up radiograph of the right knee, 1 month after surgery. The radiograph shows a correct axial alignment of the epiphysis, 1 month after surgery of the Salter-Harris type 1 fracture in coronal (A) and sagittal (B) views. There are no signs of secondary dislocation or wandering of the K-wires. Mild osseous consolidation can be seen in (B).
case_images: fped-12-1425358-g003.jpg
case_images: PMC11799265_01_fped-12-1425358-g003.jpg
case_images: F3
case_images: It confirmed maintained correct axial alignment of the fracture with no evidence of secondary dislocation (Figure 3).