[Leg length inequality and rotational deformity after traction treatment of femoral shaft fractures in children].
87 patients who experienced femoral shaft fracture at the age of two to 14 years were reviewed, on average, seven (three to 12) years after the injury occurred. Three methods of treatment had been used: Bryant skin traction, and skeletal traction using either the Weber table or the Braun frame. Patients two to three years of age at the time of injury had significantly less leg length inequality than those aged four to ten years. The reason was that in the youngest group, where which 16 out of 21 patients had been treated with skin traction, the effect of traction was less efficient and there was therefore a larger overlap of the fragments at fracture healing than in the older group, where all patients had had skeletal traction. Among ten to 14 year olds there was also less leg length inequality than among four to ten year olds. This was because of lack of growth stimulation in the oldest patients after fracture healing. The results indicate that an initial overlap of approximately 10 mm should be aimed at in patients under 11 years of age, whereas overlap should be avoided in older patients. Rotational deformity, defined as side difference in anteversion angle of 15 degrees or more, occurred in seven patients (8%), but none of them had any complaints. We conclude that traction treatment gives good results, with few complications. Over-growth remains a significant problem in children under 11 years of age.
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Ortopedisk avdeling Regionsykehuset i Trondheim.
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D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D005264:Femoral Fractures / Q000628:therapy*; D005269:Femur / Q000254:growth & development / Q000503:physiopathology*; D005592:Fracture Fixation / Q000009:adverse effects* / Q000379:methods; D017102:Fracture Healing; D006801:Humans; D007870:Leg Length Inequality / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D012399:Rotation; D014143:Traction / Q000009:adverse effects*