Abstract
Fractures in children differ in many ways from those seen in adults ; healing is rapid, pseudoarthrosis is an almost unknown occurrence, and there is a pronounced capability for remodelling. Therefore, we commonly handle children with fractures conservatively. This gives us certain freedoms as to the exact method of reduction, but obliges us to take into consideration the simultaneous effects of the healing of the fracture and the normal growth process. According to the literature, there have been many considerable achievements, but there has also some somewhat contradictory information concerning these problems. There has been a large increase in the number of traffic accident cases, and as a result of these we are increasingly expected to make accurate prognoses, and moreover the changes caused by the remarkable improvement over the last twenty years in growth and physical development. We have had experience with one hundred and nineteen (119) children with fractures in their lower limbs who were treated by traction and casting, and were re-examined 1-12 years later. The results of the radiological measurement of femoral and tibial length and alignment were analysed. Remarkable longitudinal overgrowth occurred most commonly in the 3-8 year-old range, and persisted for a very long time. The degree of the overgrowth in the femur was about 10mm., in the tibia, about 6mm. and the limit for longitudinal displacement was the same. We consider that about a 15° lateral deformity (in the tibia. about 10°) is without clinical significance and will correct itself spontaneously. However, torsional deformity will not correct itself. The prognosis for any remodelling after ten years old is very poor.
