Overgrowth of the Femur After Internal Fixation in Children With Femoral Shaft Fracture-A Multicenter Study
| Autor: | Dae-Wook Kim, Kyeong-Hyeon Park, Byoung Kyu Park, Hoon Park, Chang Wug Oh, Kun-Bo Park |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Bone healing law.invention Intramedullary rod 03 medical and health sciences Fixation (surgical) Fracture Fixation Internal 0302 clinical medicine law Fracture fixation Medicine Internal fixation Humans Orthopedics and Sports Medicine Femur Child Retrospective Studies Fracture Healing 030222 orthopedics Femur fracture business.industry 030208 emergency & critical care medicine Retrospective cohort study General Medicine Surgery Fracture Fixation Intramedullary Treatment Outcome business Femoral Fractures |
| Zdroj: | Journal of orthopaedic trauma. 34(3) |
| ISSN: | 1531-2291 |
| Popis: | Objectives To evaluate overgrowth after internal fixation for pediatric femur fracture and to identify any factors related with overgrowth in terms of fracture type and fixation method. Design Retrospective comparative study. Setting Multicenter, children's hospital and general hospital. Patients/participants Eighty-seven children between 4 and 10 years of age were included. Length-stable fracture was noted in 49 children, and length-unstable fracture was found in 38 children. Intervention Thirty-six children were treated by minimal invasive plate osteosynthesis (MIPO), and elastic stable intramedullary nail fixation (ESIN) was used in 51 children. Main outcome measurements The degree of overgrowth after internal fixation compared to fracture type, fracture site, and surgical method. Multivariable logistic regression analysis was conducted to identify factors related with overgrowth. Results The average overgrowth of the femur was 10.5 ± 7.3 mm. There was no patient who required correction for final leg length discrepancy (>2 cm). There was no significant difference in overgrowth between ESIN (9.9 ± 7.2 mm) and MIPO (11.2 ± 7.6 mm) (P = 0.417). Overgrowth was similar among length-unstable fractures (12.3 ± 7.4 mm) and length-stable fractures (9.2 ± 7.0 mm), although it was statistically greater in length-unstable fractures (P = 0.048). In the MIPO group, length-unstable fractures were associated with an increased log odds of 6.873 for overgrowth of the femur (P = 0.042). Conclusions Femur overgrowth after internal fixation seems to not be a clinically significant problem, regardless of whether that be for length-stable or length-unstable fractures and whether they were treated by MIPO or ESIN. Length-unstable fracture may be a risk factor for overgrowth in children. However, the difference is very small, and the postoperative overgrowth would likely not be a significant factor in deciding the surgical plan. Level of evidence Therapeutic Level III. See Instructions for authors for a complete description of levels of evidence. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|