From the University of Illinois College of Medicine, Department of Orthopaedic Surgery, Chicago, IL (Dr. Burton and Dr. Moon); Department of Pediatric Orthopaedic Surgery and Scoliosis, Northshore University Health System, Chicago, IL (Dr. Roberts).
J Am Acad Orthop Surg Glob Res Rev. 2023 Oct 6;7(10). doi: 10.5435/JAAOSGlobal-D-22-00220. eCollection 2023 Oct 1.
A 12-year-old girl developed a distal femoral shaft fracture treated with lateral trochanteric entry intramedullary nail fixation. The nail was retained after union because of a persistent nonossifying fibroma at the previous fracture site. At 16 months after surgery, marked valgus deformity was noted at the distal femur, with signs of implant haloing and loosening, suggesting repetitive motion and stress concentration of forces at the distal femur. Owing to recognition before skeletal maturity, the valgus was corrected with hemiepiphysiodesis. This finding illustrates the importance of follow-up up to skeletal maturity for pediatric femoral shaft fractures and consideration of routine removal of implants after fracture union to avoid this previously unreported complication.
一位 12 岁女孩因股骨远端干骨折接受外侧转子下入路髓内钉固定治疗。由于之前骨折部位持续存在非骨化性纤维瘤，在愈合后保留了钉子。术后 16 个月，在股骨远端发现明显的外翻畸形，有植入物光晕和松动的迹象，表明在股骨远端存在反复的运动和力的集中。由于在骨骼成熟前认识到这一点，采用半骺阻滞术矫正了外翻。这一发现说明了在骨骼成熟前对儿童股骨干骨折进行随访的重要性，并考虑在骨折愈合后常规取出植入物，以避免这种以前未报道的并发症。
