Bone Growth After Fracture of the Femoral Shaft in Children

Abstract

Ichiro Itonaga, Tatsuya Iwasaki, Nobuhiro Kaku and Hiroshi Tsumura

Background: Overgrowth after femoral diaphyseal fractures in children has been well-known. The process and degree of overgrowth vary among patients, making it difficult to predict the length of the fractured femur at growth arrest.

Materials and Methods: 3 cases aged 4-7 years (2 boys and 1 girl) with femoral diaphyseal fractures were subjected. Observation period was 6-12 years. Leg length was assessed by taking a simple X-ray of the entire lower extremities in a standing position.

Results: 2 cases underwent anatomical reduction and external fixation. After the fracture had healed, there was overgrowth of the fractured femur, resulting in leg length discrepancy. Both cases were treated with an 8-plate temporal epiphysiodesis. 1 case was treated conservatively with skeletal traction, and fracture was healed with overriding of bone fragments. Overgrowth occurred and resulted in a fractured femur that became longer than opposite side. However, leg length discrepancy was gradually self-corrected and was eventually eliminated.

Conclusions: Overgrowth after femoral diaphyseal fracture was seen in all patients. Overgrowth tended to occur rapidly after the fracture and then slow down. Leg length discrepancy caused by overgrowth may be corrected during growth to some degree, and it should be decided whether patient need additional treatment.

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