Complications of plate fixation of femoral shaft fractures in children and adolescents

• DOI: 10.1007/s11832-013-0496-5
• Publication Date: 2013-04-10T14:52:20Z
• Authors: Collin May; Yi-Meng Yen; Adam Y. Nasreddine; Daniel Hedequist; Michael T. Hresko; Benton E. Heyworth
• Keywords: Femur fracture; Medical record

This study aims to critically analyze the major and minor complications that may be associated with plate fixation of pediatric diaphyseal femur fractures.The medical records skeletally immature patients (6-15 years age) who underwent a fracture at tertiary-care level-1 trauma center between 1/2003 12/2010 were reviewed. Demographic clinical information regarding mechanism injury, type, surgical technique recorded. Radiographic evaluation bony healing, hardware position, deformity was performed throughout period. All intraoperative postoperative Complication incidence time from surgery complication described. Multivariate logistic regression multivariate Cox models used assess association different variables occurrence complication. Kaplan-Meier survivorship curves evaluate freedom longer follow-up.Over an 8-year period, 85 (83 % males, mean age 10.2 years) for fractures. Overall, identified in 11 (13 %). Major complications, defined as those resulting unplanned reoperation (excluding elective removal asymptomatic plate/screws), occurred five (6 %) included two (2 wound infections requiring irrigation debridement, distal femoral valgus (DFVD) leading osteotomy removal, respectively, one patient (1 3-cm leg length discrepancy (LLD) epiphysiodesis. Minor not operative intervention, six (7 delayed union, symptomatic screw prominence, superficial infection effectively treated oral antibiotics, malunion, which early follow-up. There no reports knee stiffness, shortening, or reoperations address stability. Fifty-two (61 routine without related following union. postoperatively 20 months (range 0-65 months), though later point (mean 29.1 months, range months) than 12.5 0-40.1 months). Longer follow-up higher [p = 0.0012, odds ratio 1.05, 95 confidence interval (CI): 1.02-1.08].The plating fractures is 6 7 rates respectively. minimal long-term sequelae noted. rate compares favorably published (10-62 titanium elastic nail similar types. Most >4 postoperatively, occurring complications. Long-term these recommended ensure do go undetected.Retrospective case series, Level IV.