Epidemiology and risk factors for premature physeal closure in distal femur fractures
Background and purpose: Premature physeal closure (PPC) is a common and concerning complication to distal femoral fractures as the distal growth plate accounts for 70% of the growth of the femur. The literature is not unanimous in determining the risk factors of PPC, and the epidemiological charact...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Medical Journals Sweden
2023-07-01
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| Series: | Acta Orthopaedica |
| Subjects: | |
| Online Access: | https://actaorthop.org/actao/article/view/13654 |
| _version_ | 1797780496938172416 |
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| author | Sini-Tuuli Koivisto Topi Laaksonen Ilkka Helenius Henri Vasara Antti Stenroos |
| author_facet | Sini-Tuuli Koivisto Topi Laaksonen Ilkka Helenius Henri Vasara Antti Stenroos |
| author_sort | Sini-Tuuli Koivisto |
| collection | DOAJ |
| description |
Background and purpose: Premature physeal closure (PPC) is a common and concerning complication to distal femoral fractures as the distal growth plate accounts for 70% of the growth of the femur. The literature is not unanimous in determining the risk factors of PPC, and the epidemiological characterization of these fractures is limited. Our aim was to calculate the population-based incidence and investigate risk factors for PPC in these fractures.
Patients and methods: In this register-based study, between 2014 and 2021, 70 children with distal femoral physeal fractures presented to our hospital. Demographic data, and fracture- and treatment-related details were collected using the Kids’ Fracture Tool. A directed acyclic graph (DAG) was constructed to determine confounding factors used in the risk analysis.
Results: Physeal fractures of the distal femur occurred with an annual incidence of 6/105 children, and a resulting PPC occurred in 16/70 (23%) with an annual incidence of 1.3/105 children. In multivariable analysis, dislocation exceeding 10 mm was a risk factor for PPC (OR 6.3, CI 1.4-22).
Conclusion: One-fourth of distal femoral physeal fractures developed PPC. Greater dislocation and higher injury energy were significant risk factors, whereas choice of fracture treatment was not an independent risk factor. All patients with PPC belonged in the age group 11–16 years.
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| first_indexed | 2024-03-12T23:44:58Z |
| format | Article |
| id | doaj.art-e738b07eb9bc4f128fdf88dda9535ced |
| institution | Directory Open Access Journal |
| issn | 1745-3674 1745-3682 |
| language | English |
| last_indexed | 2024-03-12T23:44:58Z |
| publishDate | 2023-07-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Orthopaedica |
| spelling | doaj.art-e738b07eb9bc4f128fdf88dda9535ced2023-07-14T11:43:10ZengMedical Journals SwedenActa Orthopaedica1745-36741745-36822023-07-019410.2340/17453674.2023.13654Epidemiology and risk factors for premature physeal closure in distal femur fracturesSini-Tuuli Koivisto0Topi Laaksonen1Ilkka Helenius2Henri Vasara3Antti Stenroos4University of Helsinki, Faculty of Medicine, Helsinki; Finnish Pediatric Orthopaedics Research Group (FIPO), Helsinki, FinlandDepartment of Pediatric Orthopaedics and Traumatology, University of Helsinki and Helsinki New Children’s Hospital, Helsinki; Finnish Pediatric Orthopaedics Research Group (FIPO), Helsinki, FinlandDepartment of Pediatric Orthopaedics and Traumatology, University of Helsinki and Helsinki New Children’s Hospital, Helsinki; Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki; Finnish Pediatric Orthopaedics Research Group (FIPO), Helsinki, FinlandDepartment of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki; Finnish Pediatric Orthopaedics Research Group (FIPO), Helsinki, FinlandDepartment of Pediatric Orthopaedics and Traumatology, University of Helsinki and Helsinki New Children’s Hospital, Helsinki; Finnish Pediatric Orthopaedics Research Group (FIPO), Helsinki, Finland Background and purpose: Premature physeal closure (PPC) is a common and concerning complication to distal femoral fractures as the distal growth plate accounts for 70% of the growth of the femur. The literature is not unanimous in determining the risk factors of PPC, and the epidemiological characterization of these fractures is limited. Our aim was to calculate the population-based incidence and investigate risk factors for PPC in these fractures. Patients and methods: In this register-based study, between 2014 and 2021, 70 children with distal femoral physeal fractures presented to our hospital. Demographic data, and fracture- and treatment-related details were collected using the Kids’ Fracture Tool. A directed acyclic graph (DAG) was constructed to determine confounding factors used in the risk analysis. Results: Physeal fractures of the distal femur occurred with an annual incidence of 6/105 children, and a resulting PPC occurred in 16/70 (23%) with an annual incidence of 1.3/105 children. In multivariable analysis, dislocation exceeding 10 mm was a risk factor for PPC (OR 6.3, CI 1.4-22). Conclusion: One-fourth of distal femoral physeal fractures developed PPC. Greater dislocation and higher injury energy were significant risk factors, whereas choice of fracture treatment was not an independent risk factor. All patients with PPC belonged in the age group 11–16 years. https://actaorthop.org/actao/article/view/13654ChildrenDistal femurEpidemiologyFemurGrowth arrestIncidence |
| spellingShingle | Sini-Tuuli Koivisto Topi Laaksonen Ilkka Helenius Henri Vasara Antti Stenroos Epidemiology and risk factors for premature physeal closure in distal femur fractures Acta Orthopaedica Children Distal femur Epidemiology Femur Growth arrest Incidence |
| title | Epidemiology and risk factors for premature physeal closure in distal femur fractures |
| title_full | Epidemiology and risk factors for premature physeal closure in distal femur fractures |
| title_fullStr | Epidemiology and risk factors for premature physeal closure in distal femur fractures |
| title_full_unstemmed | Epidemiology and risk factors for premature physeal closure in distal femur fractures |
| title_short | Epidemiology and risk factors for premature physeal closure in distal femur fractures |
| title_sort | epidemiology and risk factors for premature physeal closure in distal femur fractures |
| topic | Children Distal femur Epidemiology Femur Growth arrest Incidence |
| url | https://actaorthop.org/actao/article/view/13654 |
| work_keys_str_mv | AT sinituulikoivisto epidemiologyandriskfactorsforprematurephysealclosureindistalfemurfractures AT topilaaksonen epidemiologyandriskfactorsforprematurephysealclosureindistalfemurfractures AT ilkkahelenius epidemiologyandriskfactorsforprematurephysealclosureindistalfemurfractures AT henrivasara epidemiologyandriskfactorsforprematurephysealclosureindistalfemurfractures AT anttistenroos epidemiologyandriskfactorsforprematurephysealclosureindistalfemurfractures |