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Management of Femoral Shaft Fractures in the Adolescent
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Hyoun Oh Cho, Kyoung Kuck Kwak, Sung Do Cho, Cheol Soo Ryoo, Bub Jae Lee
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J Korean Soc Fract 1995;8(3):521-527. Published online July 31, 1995
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DOI: https://doi.org/10.12671/jksf.1995.8.3.521
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 Abstract
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- Treatment of the femoral shaft fractures in adolescents with open physis is somewhat controversial. Historically, these fractures have been treated with nonoperative methods, but adolescents are less tolerant to the prolonged irnrnobilization than younger children. Futhermore, conservative treatment in this age group may be prone to result in more complications such as malunion and shortening than that in the younger age group. Therefore many authors prefer the operative method for femoral shaft fractures in the adoleseents.
The authors reviewed 22 cases of adolescent femoral shaft fractures treated during the period from January, 1958 to June 1992. Seven cases were treated conseratively, eleven by open reduction and intenal fixation with DCP, and four by closed intramedullary nailing. The patients treated with traction and casting showed more often complications such as angular deformity and bone shortening than in the operative methods. In comparing with those cases of plating, the patients of intramedullary nailing had statistically significant shorter ansthesic time and less blood loss in operation. All of the fractures treated with the intramedullary nails healed without malunion or leg length discrepancy, and there was no evidence of growth plate arrest. Results of this study suggest that closed intramedullary nailing of femur fractures in aldolescents is an effective treatment option.
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Angular Changes after Operative Treatment for the Supracondylar fractures of the Femur
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Hyoun Oh Cho, Kyoung Duek Kwak, Sung Do Cho, Cheol Soo Ryoo, Bub Jae Lee
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J Korean Soc Fract 1994;7(1):174-180. Published online May 31, 1994
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DOI: https://doi.org/10.12671/jksf.1994.7.1.174
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Abstract
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- A fractures of the distal femur is an extremely complex fracture with which to deal. Poor bone stock, proximity to the knee joint, and a truncated shape make this area of the femur less suitable for internal fixation than other areas. Ideal care still somewhat controversial. Major complications include nonunion, delayed union, infection, loss of fixation, Joint stiffness and angular deformity, etc.
The authors reviewed postoperative tiblo-femoral angular changes from the twenty six cases of supracondylar and intercondylar fractures of the femur treated operatively from January, 1988 to December, 1991. Fractures of a single condyle were excluded. The fractures were fixed internally with dynamic condylar screw(DCS) in nine cases, anatomic plate in nine, dynamic compression plate(DCP) in six and others in two. During the periods of follow up there noted varus change of 3.7 degrees in average. We reviewed retrospectively these postoperative varus or valgus angular changes with reference to the degree of injury, type of fracture, time elapsed from injury to operation, kind of internal fixation device, initial bone graft and postoperative brace supplement. Less angular changes in the tiblo-femoral angle with better results were noted in cases with lower energy injuries, AO type Al, A2 or Cl fractures, operation within 1 week of injury, internal fixation with DCS, initial bone graft and postoperative corrective brace supplement.
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