Table of Contents
Advances in Orthopedic Surgery
Volume 2014, Article ID 305247, 4 pages
Research Article

The Effect of a Femoral Fracture Sustained before Skeletal Maturity on Bone Mineral Density: A Long-Term Follow-Up Study

1Arcada University of Applied Sciences, Jan-Magnus Janssonin Aukio 1, 00550 Helsinki, Finland
2Children’s Hospital, Helsinki University Central Hospital, P.O. Box 281, 00029 Helsinki, Finland
3Tampere Center for Child Health Research (TACC), University of Tampere and Tampere University Hospital, Lääkärinkatu 1, 33014 Tampere, Finland
4Orton Orthopaedic Hospital, Orton Foundation, P.O. Box 29, 00281 Helsinki, Finland
5Department of Radiology, HUS Medical Imaging Center, Helsinki University Central Hospital and University of Helsinki, P.O. Box 340, 00029 Helsinki, Finland

Received 28 June 2014; Revised 21 November 2014; Accepted 23 November 2014; Published 21 December 2014

Academic Editor: Werner Kolb

Copyright © 2014 J. A. Kettunen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background and Purpose. The possible effect of pediatric femoral fractures on the bone mineral density (BMD) is largely unknown. We conducted a study to investigate BMD in adults who had sustained a femoral shaft fracture in childhood treated with skeletal traction. Materials and Methods. Forty-four adults, who had had a femoral fracture before skeletal maturity, were reexamined on average 21 (range 11.4) years after treatment. Our follow-up study included a questionnaire, a clinical examination, length and angle measurements of the lower extremities from follow-up radiographs, and a DEXA examination with regional BMD values obtained for both legs separately. Results. At follow-up femoral varus-valgus and ante-/recurvatum angles were slightly larger in the injured lower-limb compared to the contralateral limb. The mean BMD of the entire injured lower-limb was lower than that of the noninjured (1.323 g/cm2 versus 1.346 g/cm2, ). Duration of traction was the only factor in multiple linear regression analysis that was positively correlated with the BMD discrepancy between the injured and noninjured lower-limb explaining about 17% of its variation. Conclusion. The effect of a femoral fracture sustained during growth is small even in patients treated with traction.