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. 2021 Jun 1;15(3):215-222.
doi: 10.1302/1863-2548.15.200252.

Leg-length discrepancy and associated risk factors after paediatric femur shaft fracture: a multicentre study

Tae Gyun Kim  1 , Moon Seok Park  2   3 , Sang Hyeong Lee  4 , Kug Jin Choi  2 , Byeong-Eun Im  2 , Dae Yeung Kim  1 , Ki Hyuk Sung  2   3
Affiliations

Leg-length discrepancy and associated risk factors after paediatric femur shaft fracture: a multicentre study

Tae Gyun Kim et al. J Child Orthop. .

Abstract

Purpose: This study was performed to investigate leg-length discrepancy (LLD) and associated risk factors after paediatric femur shaft fractures.

Methods: A total of 72 consecutive patients under 13 years old (mean age 6.7 years; 48 boys, 24 girls) with unilateral femur shaft fracture, and a minimum follow-up of 18 months, were included. The amount of LLD was calculated by subtracting the length of the uninjured from that of the injured limb. Risk factors for an LLD ≥ 1 cm and ≥ 2 cm were analyzed using multivariable logistic regression analysis.

Results: Hip spica casting, titanium elastic nailing and plating were performed on 22, 40 and ten patients, respectively. The mean LLD was 7.8 mm (sd 8.8) and 29 (40.3%) had a LLD of ≥ 1 cm, while nine (12.5%) had a LLD of ≥ 2 cm. There were significant differences in fracture stability (p = 0.005) and treatment methods (p = 0.011) between patients with LLD < 1 cm and ≥ 1 cm. There were significant differences in fracture site shortening (p < 0.001) and LLD (p < 0.001) between patients with length-stable and length-unstable fractures. Fracture stability was the only factor associated with LLD ≥ 1 cm (odds ratio of 4.0; p = 0.020) in the multivariable analysis.

Conclusion: This study demonstrated that fracture stability was significantly associated with LLD after paediatric femur shaft fractures. Therefore, the surgeon should consider the possibility of LLD after length-stable femur shaft fracture in children.

Level of evidence: Prognostic level III.

Keywords: femur shaft fracture; leg-length discrepancy; overgrowth; paediatric.

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Figures

Fig. 1
Fig. 1
Whole limb length was defined as the length from the top of the femoral head to the center of the tibial plafond.
Fig. 2
Fig. 2
Inclusion and exclusion criteria.
See this image and copyright information in PMC

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