Bone overgrowth following diaphyseal fracture femur in children

Abstract EN

Background: Femoral shaft fractures are common in children and leg length discrepancy is the most common complication.

The overgrowth phenomenon is a physiological process associated with posttraumatic hyperemia rather than compensatory to the discrepancy.

Objectives: To evaluate the femoral discrepancy at time of union and the rate of overgrowth after one year of union following diaphyseal fracture of femur in children.

Also to find the factors that accelerates the overgrowth phenomenon.

Patients and methods: this is a prospective study includes 20 children with closed diaphyseal femoral fractures, who were admitted to the orthopedic department in Duhok Emergency Teaching Hospital between August 2010 and September 2011, their age ranged from 1.3-7 years, 14 male and 6 female, fall from height was the most common cause of fracture, thirteen patients were treated conservatively and the other treated operatively.

Follow up was done-twice for each patient- at time of union both clinically and radiologically and 12 months afterwards.

The time of union ranged between 6-9 weeks.

Results: Shortening at time of union was noticed in 95% of fractured femur.

After one year from union According to clinical measurement, overgrowth occurred in (16) 80% of cases with an average of 3.5 mm per year.

By radiological assessment overgrowth occurred in 100% of the cases with an average of 8.4mm.It has been found that average bone overgrowth differs according to type of fracture and the site of fracture.

Average overgrowth in those who had shortening of 1 cm or more at the time of union was 12mm and for those who had shortening of less than 1cm was 8 mm and this was statistically significant.

Conclusions: Cases with oblique fracture in the proximal third with shortening of one cm or more showed greater tendency to correct shortening.

Incidence of femoral shortening following fracture femur was very high.