J Korean Orthop Assoc.  2012 Oct;47(5):353-359. 10.4055/jkoa.2012.47.5.353.

A Comparison of Overgrowth after Treatment for Pediatric Femoral Shaft Fractures: Flexible Intramedullary Nailing versus External Fixation

• Kim HY
• Lee SM
• Park KH
• Choy WS

• KMID: 2185319
• DOI: http://doi.org/10.4055/jkoa.2012.47.5.353

Abstract

PURPOSE
Overgrowth is a common complication after the treatment of pediatric femoral fractures. However, the effect of treatment methods on the overgrowth is controversial. We compared the amount of overgrowth between flexible intramedullary nailing and external fixation.
MATERIALS AND METHODS
Twenty-six children with femoral diaphyseal fractures after a minimum 2 year follow-up were enrolled in this retrospective study. Thirteen patients were treated with flexible intramedullary nailing (FIN) group, and the other 13 patients were treated with external fixation (EF) group. The overgrowth of femur, clinical outcomes, and complications were evaluated.
RESULTS
Union was obtained in all patients without major complications, except for overgrowth. Average overgrowth at the 2-year follow-up was 4 mm (-6-13 mm) in the FIN group, and 3 mm (-13-13 mm) in the EF group (p=0.532). Overgrowths of more than 10 mm were observed in four patients; three patients in the FIN group, and one in the EF group.
CONCLUSION
FIN and EF showed similar amounts of overgrowth, after the treatment for pediatric femoral fractures.

Keyword

femur; femoral fractures; overgrowth; flexible intramedullary nailing; external fixation

MeSH Terms

Child
Femoral Fractures
Femur
Follow-Up Studies
Fracture Fixation, Intramedullary
Humans
Retrospective Studies

Figure

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  Figure 1 (A) A transverse diaphyseal femoral fracture in a 7-year-old boy. (B) Flexible intramedullary nail was applied. (C) Radiograph at 14 months after the fracture.

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  Figure 2 (A) A transverse diaphyseal femoral fracture in a 7-year-old boy. (B) External fixator was applied. (C) Radiograph at 15 months after the fracture.

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