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

Author:

Kim Tae Gyun1,Park Moon Seok23,Lee Sang Hyeong4,Choi Kug Jin2,Im Byeong-eun2,Kim Dae Yeung1,Sung Ki Hyuk23ORCID

Affiliation:

1. Department of Orthopaedic Surgery, Konyang University Hospital, Daejeon, Korea

2. Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Gyeonggi, Korea

3. Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Korea

4. Department of Orthopaedic Surgery, Dongguk University Ilsan Hospital, Gyeonggi, Korea

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

Publisher

SAGE Publications

Subject

Orthopedics and Sports Medicine,Pediatrics, Perinatology and Child Health

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