Overgrowth of the Lower Extremity Following Fractures in Children : Influence of Handedness

Abstract

It is well known that longitudinal overgrowth occurs after fracture in children. The factors which are considered to affect this phenomenon include age, and site and type of fracture. However, interrelation and difference of clinical significance of these factcrs have not been yet elucidated, In this study, we showed that a statistically significant difference occurs according to cerebral control : namely whether the fracture is on the same side with or opposite site of the dominant hand. A total of 107 cases (consisting of 46 cases of femoral fracture and 61 cases of tibial fracture) were included as the study subjects. Among the cases of femoral fracture, there were 20 cases of dominant side fracture with a mean overgrowth of 7.8mm and 26 cases of non-dominant side fracture with a mean of 12.1mm (p<0.05). For tibial fracture, there were 38 cases of dominant with a mean of 5.7mm overgrowth and 23 cases of non-dominant with a mean of 6.3mm overgrowth (p<0.05). Only in cases of femoral fracture, significant difference at p<0.05 was seen. Similar findings were reported by Meals in 1979. It may be postulated that the leg on the non-dominant side controls the balance at the time of standing up and walking, and this burden will increase the blood flow which may produce overgrowth.