{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T02:14:37Z","timestamp":1768875277193,"version":"3.49.0"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:sec>\n            <jats:title>Objectives:<\/jats:title>\n            <jats:p>To evaluate overgrowth after internal fixation for pediatric femur fracture and to identify any factors related with overgrowth in terms of fracture type and fixation method.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Design:<\/jats:title>\n            <jats:p>Retrospective comparative study.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Setting:<\/jats:title>\n            <jats:p>Multicenter, children's hospital and general hospital.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patients\/Participants:<\/jats:title>\n            <jats:p>Eighty-seven children between 4 and 10 years of age were included. Length-stable fracture was noted in 49 children, and length-unstable fracture was found in 38 children.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Intervention:<\/jats:title>\n            <jats:p>Thirty-six children were treated by minimal invasive plate osteosynthesis (MIPO), and elastic stable intramedullary nail fixation (ESIN) was used in 51 children.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Main Outcome Measurements:<\/jats:title>\n            <jats:p>The degree of overgrowth after internal fixation compared to fracture type, fracture site, and surgical method. Multivariable logistic regression analysis was conducted to identify factors related with overgrowth.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>The average overgrowth of the femur was 10.5 \u00b1 7.3 mm. There was no patient who required correction for final leg length discrepancy (&gt;2 cm). There was no significant difference in overgrowth between ESIN (9.9 \u00b1 7.2 mm) and MIPO (11.2 \u00b1 7.6 mm) (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.417). Overgrowth was similar among length-unstable fractures (12.3 \u00b1 7.4 mm) and length-stable fractures (9.2 \u00b1 7.0 mm), although it was statistically greater in length-unstable fractures (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.048). In the MIPO group, length-unstable fractures were associated with an increased log odds of 6.873 for overgrowth of the femur (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.042).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Femur overgrowth after internal fixation seems to not be a clinically significant problem, regardless of whether that be for length-stable or length-unstable fractures and whether they were treated by MIPO or ESIN. Length-unstable fracture may be a risk factor for overgrowth in children. However, the difference is very small, and the postoperative overgrowth would likely not be a significant factor in deciding the surgical plan.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Level of Evidence:<\/jats:title>\n            <jats:p>Therapeutic Level III. See Instructions for authors for a complete description of levels of evidence.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/bot.0000000000001652","type":"journal-article","created":{"date-parts":[[2019,9,22]],"date-time":"2019-09-22T21:28:51Z","timestamp":1569187731000},"page":"e90-e95","source":"Crossref","is-referenced-by-count":19,"title":["Overgrowth of the Femur After Internal Fixation in Children With Femoral Shaft Fracture\u2014A Multicenter Study"],"prefix":"10.1097","volume":"34","author":[{"given":"Kyeong-Hyeon","family":"Park","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Byoung Kyu","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Inje University Haeundae Paik Hospital, Busan, Korea;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang-Wug","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dae-Wook","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Inje University Haeundae Paik Hospital, Busan, Korea;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hoon","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kun-Bo","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-20230828","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1097\/01.bpo.0000164872.44195.4f","article-title":"Complications of pediatric femur fractures treated with titanium elastic nails: a comparison of fracture types","volume":"25","author":"Sink","year":"2005","journal-title":"J Pediatr Orthop."},{"key":"R2-20230828","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1097\/01241398-200101000-00003","article-title":"Titanium elastic nails for pediatric femur fractures: a multicenter study of early results with analysis of complications","volume":"21","author":"Flynn","year":"2001","journal-title":"J Pediatr Orthop."},{"key":"R3-20230828","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1097\/bpo.0b013e31815ff301","article-title":"Locking plate fixation for pediatric femur fractures","volume":"28","author":"Hedequist","year":"2008","journal-title":"J Pediatr Orthop."},{"key":"R4-20230828","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1097\/BPO.0b013e31824b7500","article-title":"Biomechanical analysis comparing titanium elastic nails with locked plating in two simulated pediatric femur fracture models","volume":"32","author":"Porter","year":"2012","journal-title":"J Pediatr Orthop."},{"key":"R5-20230828","doi-asserted-by":"crossref","first-page":"596","DOI":"10.5435\/00124635-201209000-00006","article-title":"Submuscular plating of pediatric femur fracture","volume":"20","author":"Li","year":"2012","journal-title":"J Am Acad Orthop Surg."},{"key":"R6-20230828","doi-asserted-by":"crossref","first-page":"2797","DOI":"10.1007\/s11999-013-2931-9","article-title":"Submuscular bridge plating for complex pediatric femur fractures is reliable","volume":"471","author":"Abdelgawad","year":"2013","journal-title":"Clin Orthop Relat Res."},{"key":"R7-20230828","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1302\/0301-620X.68B4.3733825","article-title":"Overgrowth of the femur after fracture in childhood. 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