Limb length discrepancy following fracture of the femoral shaft in children

ABSTRACT

Limb discrepancy could be considered the most frequent complication of femoral shaft fracture in children. This paper reviews the literature concerning the possible mechanisms of growth stimulation and the correlations between overgrowth and age, site and type. In a review of 41 children aged between 0 and 13 years with simple femoral shaft fracture, treated at the Royal Liverpool Children's Hospital between 1973 and 1979, who had a radiological 'grid film' and/or a clinical measurement, a final check showed a limb discrepancy in almost 50% of the cases. These data reveal that no overgrowth occurred in patients who sustained the fracture below the age of 1 year, while those over the age of 1 showed a range of overgrowth of 0.5-2.0 cm. It was concluded that almost anatomical reduction is advisable in children below the age of 1 year, while in those aged 1-13 years an overlap of 1 cm is ideal