[Late results following femoral shaft fractures in childhood]

Abstract

The results of 102 children with fractures of the femur shaft treated by osteosynthesis with dynamic compression plates (DCP) in comparison to 87 children which underwent a conservative treatment by extension are presented. Of 329 patients in a 15-years period, 238 children had a follow-up examination with evaluable data and 49 patients were excluded because of a different therapy such as plaster traction, cast, osteosynthesis with screws or nails etc. The children were divided into two groups: series I from 1968 to 1977 and series II from 1978 to 1982. 19.6% of the patients had a residual difference of more than 1 cm in the length of the legs. Operated children were twice as often afflicted as the conservative group. The amount of difference in the length depended on the duration of instability and increased when several repositions were required in the conservative group, or when an operation was carried out secondary to inadequate traction therapy. Axial deviation was found to be much more common in the extended group (16.1%) than in the operated group, in which only 4% axial deviations persisted in series II when DC-plates were used exclusively. Predominant in the conservative group was a persisting antecurvation in 13 of 14 children. Residual rotation malalignment of significant degree was found only in the group treated by extension, while the operated group averosed at minor torsion deformities. Children with closed epiphysis on the date of examination, who had a persisting rotation failure, had been treated nearly exclusively by extension (50% versus 15%).(ABSTRACT TRUNCATED AT 250 WORDS)