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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 characte...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Medical Journals Sweden, on behalf of the Nordic Orthopedic Federation
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10348013/ https://www.ncbi.nlm.nih.gov/pubmed/37449728 http://dx.doi.org/10.2340/17453674.2023.13654 |
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author | KOIVISTO, Sini-Tuuli LAAKSONEN, Topi HELENIUS, Ilkka VASARA, Henri STENROOS, Antti |
author_facet | KOIVISTO, Sini-Tuuli LAAKSONEN, Topi HELENIUS, Ilkka VASARA, Henri STENROOS, Antti |
author_sort | KOIVISTO, Sini-Tuuli |
collection | PubMed |
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 6/10(5) children, and a resulting PPC occurred in 16/70 (23%) with an annual incidence of 1.3/10(5) 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. |
format | Online Article Text |
id | pubmed-10348013 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Medical Journals Sweden, on behalf of the Nordic Orthopedic Federation |
record_format | MEDLINE/PubMed |
spelling | pubmed-103480132023-07-15 Epidemiology and risk factors for premature physeal closure in distal femur fractures KOIVISTO, Sini-Tuuli LAAKSONEN, Topi HELENIUS, Ilkka VASARA, Henri STENROOS, Antti Acta Orthop Article 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 6/10(5) children, and a resulting PPC occurred in 16/70 (23%) with an annual incidence of 1.3/10(5) 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. Medical Journals Sweden, on behalf of the Nordic Orthopedic Federation 2023-07-12 /pmc/articles/PMC10348013/ /pubmed/37449728 http://dx.doi.org/10.2340/17453674.2023.13654 Text en © 2023 The Author(s) https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for non-commercial purposes, provided proper attribution to the original work. |
spellingShingle | Article KOIVISTO, Sini-Tuuli LAAKSONEN, Topi HELENIUS, Ilkka VASARA, Henri STENROOS, Antti Epidemiology and risk factors for premature physeal closure in distal femur fractures |
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 | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10348013/ https://www.ncbi.nlm.nih.gov/pubmed/37449728 http://dx.doi.org/10.2340/17453674.2023.13654 |
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