Factors associated with refracture after surgery for femoral shaft fracture in children

Abstract

Objective To analyze the factors influencing the incidence of refracture after surgery for femoral shaft fracture in children and put forward their countermeasures. Methods A retrospective study was conducted in the children who had been treated at Department I of Pediatric Orthopaedics, Zhengzhou Orthopaedic Hospital from September 2013 to May 2017 for primary femoral shaft fracture or refracture after surgery for femoral shaft fracture. Their clinic data were collected concerning age, gender, height, weight, primary fracture, treatment protocol, time for removal of fixation, time and site of refracture, and violence for refracture. The likely factors associated with refracture were identified by comparing the gender ratios, age distributions and primary fractures between the children with primary fracture and those with refracture, and by comparing the proportions of overweight and obese ones between the children with refracture and their normal counterparts. Results A total of 278 children, with a male to female ratio of 2.43∶1, were treated for primary femoral shaft fracture while 22 children, with a male to female ratio of 0.83∶1, for refracture contemporarily. In the children with primary fracture and those with refracture, respectively, there were 172 (61.9%) cases and 2 cases (9%) aged from 0 to 4 years, 85 cases (30.6%) and 10 cases (45.5%) aged from 5 to 9 years, 21 cases (7.5%) and 10 cases (45.5%) aged from 10 to 14 years. There were significant differences between the 2 groups in gender ratio and proportions of age (P 0.05). Conclusions Refracture after surgery for femoral shaft fracture in children may be closely associated with their gender, age and overweight. Care should be taken to avoid refracture in children with high risks. Key words: Femoral fractures; Risk factors; Child; Sex factors; Body weight