Should we really compress the fracture line in the treatment of Salter-Harris type 4 distal femoral fractures? A biomechanical study

Abstract

In this study, the indirect effect on physeal plate during interfragmentary compression of a Salter-Harris (SH) type 4 distal femoral fracture has been investigated. Three Dimensional (3D) model of a single configuration has been performed via SolidWorks. ANSYS Workbench software was used for numerical analyses. All boundary conditions have been defined in finite element analysis software. Since it is premature to state that compression created an additional stress load on the physeal plate in vivo, according to our results, it has been found that lateromedial compression in SH type 4 fracture of the distal femur caused an additional stress load on the physeal plate ex vivo. It is believed that screws need to be fixed without compression to avoid an additional iatrogenic physeal injury.