Surgical Management of Left Distal Femoral Physeal Salter-Harris Type I Fracture in a 4-Month-Old Female Lhasa Apso

Japheth Joel Kalang; Paul Iliya Sambo

doi:10.5455/JRVS.20250123053139

Abstract
The Salter-Harris classification grades fractures based on the involvement of the physis, metaphysis, and epiphysis, with significant implications for prognosis and treatment. A 4-month-old, 4.4kg female Lhasa Apso was presented to VTH-UJ, with non-weight-bearing lameness in left hind limb after a road traffic accident. Clinical examination revealed warmth, swelling, tenderness, and crepitus in the left distal thigh, suggestive of a distal third femoral fracture. Radiographic evaluation confirmed a left distal femoral physeal Salter-Harris type I fracture. Prompt management through open reduction and internal fixation with an intramedullary (IM) pin was undertaken. Postoperative wound care and administration of diclofenac and gentamycin followed for 3 to 5 days. The puppy demonstrated significant improvement, bearing weight on the affected limb 15 days after, with radiographic evidence of good bone healing at 4 weeks post-operatively. This report underscores the importance of accurate diagnosis and timely treatment initiation as well as flexible surgical decision-making in the management of physeal fractures, particularly in resource-constrained settings. A 1-year follow-up revealed excellent bone healing and a complete return to normal limb function without growth disturbance.

Key words: Salter-Harris fracture; distal femoral physis; open reduction; intramedullary (IM) pin; Lhasa Apso