REMODELING OF ANGULAR DEFORMITY AFTER FEMORAL-SHAFT FRACTURES IN CHILDREN

We reviewed 28 children with unilateral middle-third fractures of the femoral shaft who had an angular deformity after union of 10-degrees to 26-degrees. At an average follow-up of 45 months (20 to 66), we measured remodelling of the proximal physis, the distal physis and the femoral shaft. The average correction was 85% of the initial deformity. We found that 74% of correction occurred at the physes and only 26% at the fracture site. Neither the direction nor the magnitude of the angulation much influenced the degree of remodelling. Younger children remodelled only a little better than older children. We conclude that in children under 13 years of age, malunion of as much as 25-degrees in any plane will remodel enough to give normal alignment of the joint surfaces.