Hougaard K
Department of Orthopaedic Surgery Theta, Odense University Hospital, Denmark.
Injury. 1989 May;20(3):170-2. doi: 10.1016/0020-1383(89)90092-2.
All children with fracture of the femoral shaft treated from August 1978 to December 1983 inclusive, comprised the study series. The object of the investigation was to determine whether a relationship could be demonstrated between shortening at the time of healing and the magnitude of overgrowth during the following 2 years. Radiographic measurements of both lower limbs were carried out at 6 weeks and 6, 12 and 24 months after the accident. During the period of the investigation 109 children suffered femoral fractures. Of these, 67 (61 per cent) met the criteria for inclusion in the study. The investigation could not demonstrate any relationship between shortening at the time of healing and the magnitude of overgrowth 2 years later. Neither was it possible to demonstrate any relationship between sex, age, type of fracture, level of fracture, and the magnitude of the overgrowth. The mean overgrowth was 10.8 mm and the largest 26 mm. Almost all children who healed with little shortening showed no angulation, and their average age was considerably below that of the series as a whole, while almost all femoral shaft fractures which healed with considerable shortening had some angulation and the average age of these children was much higher than that of the whole series. The importance of angulation in respect of shortening after femoral shaft fracture in children has not previously been reported.
