The physis of the distal femur contributes to 70% of femoral growth and 37% of the total limb growth; therefore, physeal injury can lead to important alterations of axes and length.Distal metaphyseal corner-type fracture prior to walking is classically associated with child abuse. In children aged >10 years, sports-related fractures and car accidents are significant contributors.Imaging includes a two-plane radiographic study of the knee. It is recommended to obtain radiographs that include the entire femur to rule out concomitant injuries. In cases of high suspicion of distal metaphyseal fractures and no radiographic evidence, CT or MRI can show the existence of hidden fractures.Fractures with physeal involvement are conventionally classified according to the Salter–Harris classification, but the Peterson classification is also recommended as it includes special subgroups.Conservative and surgical management are valid alternatives for the treatment of these fractures. Choosing between both alternatives depends on factors related to the fracture type.As there is a high risk of permanent physeal damage, long-term follow-up is essential until skeletal maturity is complete.

中文翻译：

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儿童股骨远端骨折

股骨远端的骨骺贡献了股骨生长的70%和肢体总生长的37%；因此，骺端损伤会导致轴和长度的重要改变。行走前的远端干骺端角型骨折通常与虐待儿童有关。对于 10 岁以上的儿童，与运动相关的骨折和车祸是重要的诱因。影像学检查包括膝盖的两平面射线照相研究。建议获取包括整个股骨的 X 光片，以排除伴随损伤。在高度怀疑远端干骺端骨折且无影像学证据的情况下，CT或MRI可显示隐性骨折的存在。 累及骺端的骨折传统上根据Salter-Harris分类进行分类，但也推荐使用Peterson分类，因为它包括特殊亚组。保守治疗和手术治疗是治疗这些骨折的有效选择。两种选择之间的选择取决于与骨折类型相关的因素。由于永久性骨骺损伤的风险很高，因此长期随访至关重要，直到骨骼成熟为止。