title: Muscle strength in children treated for displaced femoral fractures by external fixation: 31 patients compared with 31 matched controls.
abstract: In a prospective study (1993-2000), we measured the isokinetic strength of the quadriceps and hamstring muscles in 31 children aged 5-17 years, on average, 3 (1.5-5) years after treatment for a displaced femoral fracture by external fixation and early mobilization. A group of age-, sex- and weight-matched children without previous injury were used as controls. The hop-index test was used to assess the patient's confidence in the injured limb and was similar in the fractured and unfractured legs as well as in the patients and controls. We measured the peak torque output at 2 angular velocities (60 degrees/s and 180 degrees/s) in the hamstring and quadriceps muscles, using Cybex testing equipment. Torque to body weight ratios were used to compare muscle strength in patients and controls. We found no differences in muscle strength between patients and controls or in the distribution of which leg was stronger, equal or weaker in the patients or controls at any test speed. External fixation and early mobilization seem to prevent residual muscle weakness, which occurs with traction or a cast for femoral fractures in children.
authors.affiliation: Orthopaedic Department, Falun Hospital, SE-791 82 Falun, Sweden. hanne.hedin@ltdalarna.se
authors.forename: Hanne
authors.initials: H
authors.lastname: Hedin
authors.forename: Sune
authors.initials: S
authors.lastname: Larsson
mesh_terms: D000293:Adolescent; D001835:Body Weight; D016022:Case-Control Studies; D002370:Casts, Surgical / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D004434:Early Ambulation; D016267:External Fixators; D005260:Female; D005264:Femoral Fractures / Q000628:therapy*; D005592:Fracture Fixation / Q000379:methods*; D017102:Fracture Healing; D007839:Functional Laterality; D006801:Humans; D008297:Male; D018908:Muscle Weakness / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control*; D011446:Prospective Studies; D020127:Recovery of Function; D012727:Sex Characteristics; D013997:Time Factors; D019415:Torque; D014143:Traction / Q000009:adverse effects; D016896:Treatment Outcome; D016474:Weight-Bearing