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

Ha-Yong Kim; Sang Min Lee; Kyung-Hoon Park; Won-Sik Choy

doi:10.4055/jkoa.2012.47.5.353

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Kim, Lee, Park, and Choy: A Comparison of Overgrowth after Treatment for Pediatric Femoral Shaft Fractures: Flexible Intramedullary Nailing versus External Fixation

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2012; 47(5): 353-359.

Published online: 30 October 2012

DOI: https://doi.org/10.4055/jkoa.2012.47.5.353

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

Ha-Yong Kim, M.D., Sang Min Lee, M.D., Kyung-Hoon Park, M.D., Won-Sik Choy, M.D.

Department of Orthopedic Surgery, Eulji University College of Medicine, Daejeon, Korea.

Correspondence to: Sang Min Lee, M.D. Department of Orthopedic Surgery, Eulji University Hospital, 95, Dunsanseo-ro, Seo-gu, Daejeon 302-799, Korea. TEL: +82-42-611-3271, FAX: +82-42-259-1289, smlee@eulji.ac.kr

Received 25 December 2011 Revised 21 April 2012 Accepted 2 July 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: femur, femoral fractures, overgrowth, flexible intramedullary nailing, external fixation

Figures and Tables

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.

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.

Table 1

Demographics and Clinical Status of the Patients

Values are presented as mean±standard deviation (range) or number.

^*Wilcoxon Mann-Whitney test, ^†Fisher exact test.

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