Correction by Growth of Rotational Deformity After Femoral Fracture in Children

Hägglund, Gunnar; Hansson, Lars; Norman, Olof

doi:10.3109/17453678308992922

Cited by 24 publications

(12 citation statements)

References 5 publications

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“…In long-term analyses, the study group of Stephens [36] as wells as a Danish paper by Hougaard [17] show that increased leg growth is independent of the type and localization of the fracture, the patient's sex, and the method used. Most authors see no advantage in prophylactic shortening of the fracture in order to reduce the differences in leg length [8,9,11,12]. Most publications show a leg length discrepancy between 0.5 and 2.5 cm, although an idiopathic factor of 0.7 cm must be taken into consideration [7,17,38].…”

Section: Effectivenessmentioning

confidence: 99%

“…Despite good results, this treatment modality was abandoned. The decisive factors for this change in treatment were the child's requirements, an adequate treatment concept and economic aspects [1,6,9,12,14,15,19,20,24,38]. A child-oriented therapy should aim at a short hospital stay and an early mobilitation to be able to play or to go back to school.…”

Section: Introductionmentioning

confidence: 99%

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External Fixation of Pediatric Femoral Shaft Fractures Treatment and Results of 121 Fractures

et al. 2000

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From 1988From to 1996 femoral shaft fractures in children were treated by external fixation. The average age was 8.4 years (range: 2 to 16 years). Thirty-three children sustained multiple injuries (27%), and 13 children had 2nd-or 3rd-degree open fractures (10.7%). This study not only analyzes the expenditure of the operation and the corresponding follow-up period, but also the complications and the final results. The average operation time was 1 h (range: 0.2 to 2.8 h). The infection rate was 6.6%. Removal of the external fixator was carried out in 35.5% of the cases on an outpatient basis. Refractures were noted in 7 cases (5.8%). The time of consolidation was 55.3 days on average (range: 36 to 94 days) and depended on the fracture type as well as on the fixator type. By using the dynamic fixation models the consolidation time could be reduced to 46 days in comparison to the stiff AO fixation models with a mean consolidation time of 68 days. Oblique and transverse fractures showed an average healing time of 54 days. Complications such as refractures, infections, delayed unions and changes in therapy mainly occurred after oblique fractures. The average follow-up time was 32 ± 18.7 months (range: 24 to 64 months). The extent of leg length differences, on average 1.3 cm, depended on the delay of surgical intervention. There was no clinical evidence of malangulation (by definition > 20°). The results do not differ from other operative procedures. The external fixator proved to be a valuable method for the treatment of pediatric femoral shaft fractures: hospital stay is reduced and full weight bearing can be achieved early. However, transverse fractures, which showed the highest complication rate, should be treated by intramedullary nailing.

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Section: Effectivenessmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

External Fixation of Pediatric Femoral Shaft Fractures Treatment and Results of 121 Fractures

et al. 2000

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“…Several experimental studies performed on animals showed a modification of columnar orientation in the physis (with a helical growth of the physis [6,15]) as a response to torsional forces [16], and some clinical studies showed a capacity of correction, especially in the first years after a femoral fracture [17] and in younger children [18], as recorded in our experience. Yet, other studies (supported by repeated CT scans of femoral torsion [14]) ruled out any capacity of rotational remodelling in the first years after a fracture.…”

Section: Discussionmentioning

confidence: 66%

Remodelling and overgrowth after conservative treatment for femoral and tibial shaft fractures in children

et al. 2008

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One thousand nine hundred and eighty-four children who had received conservative treatment for shaft (diaphyseal and metadiaphyseal) fractures of lower limbs (1162 femoral, 822 tibial fractures) at an average age of 8.5 years (range 0-14 years) were reviewed by clinical and radiographic investigations at an average follow-up of 6.6 years (1-15 years). Particularly, two main features were evaluated: remodelling of (angular and rotational) deformities and post-traumatic overgrowth. Mechanisms underlying these processes are discussed, based on a review of the literature, and parameters conditioning their evolution are analysed. Finally, criteria for an acceptable reduction (and limits for residual deformities that may be tolerated) at the time of conservative treatment are proposed.

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“…However, other authors have reported correction by growth of torsional deformities (Laer 1977, Verbeek 1979, Brouwer et al 1981, Hagglund et a]. 1983.…”

Section: Introductionmentioning

confidence: 99%

Spontaneous correction of femoral torsion: Diaphyseal osteotomies studied in kittens

Husby

Sudmann

Gjerdet

et al. 1987

Acta Orthopaedica Scandinavica

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Inward or outward torsion of about 25 degrees was produced in the right femur of kittens by midshaft osteotomy and plate fixation. The left femurs served as controls. The anteversion angle of the femoral necks was measured in axial radiographs taken preoperatively and up to 58 weeks postoperatively. As the bones grew in length, the difference in the anteversion angle between matched femurs was gradually corrected.

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Correction by Growth of Rotational Deformity After Femoral Fracture in Children

Cited by 24 publications

References 5 publications

External Fixation of Pediatric Femoral Shaft Fractures Treatment and Results of 121 Fractures

External Fixation of Pediatric Femoral Shaft Fractures Treatment and Results of 121 Fractures

Remodelling and overgrowth after conservative treatment for femoral and tibial shaft fractures in children

Spontaneous correction of femoral torsion: Diaphyseal osteotomies studied in kittens

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