Bone Overgrowth after Femoral Shaft Fracture in Children Managed by Operative Versus Non-Operative Techniques in Sulaimani City


  • Dashty Sirwan Mohammad Rashid MBChB, KHCMS Trainee, Department of Orthopedics, Shar Teaching Hospital, Sulaimani Directorate of Health, Kurdistan region of Iraq
  • Omar Ali Rafiq Barawi MBChB, FICMS, Professor of Orthopedics, Branch of Clinical Sciences (BCS) College of Medicine, University of Sulaimani, Kurdistan region of Iraq
  • Asou Ali Bakir *MBChB, MRCS, Department of Orthopedics, Shar Teaching Hospital, Sulaimani Directorate of Health, Kurdistan region of Iraq


Bone overgrowth,Bone overgrowth, Bone shortening, Clinical assessment, Comparative study, Fracture management, X-ray


Background and objectives: Femoral overgrowth is not related to age, fracture level, or fracture
anatomical location. This study measures the amount of bone overgrowth in operative and non-operative
ways to manage femoral shaft fractures in children.
Methods: In this prospective cohort study, 50 participants with femoral shaft fractures were recruited at
Shar/Shorsh teaching hospitals from June 2022 to June 2023. We collected patients' socio-demographics
and clinical data (fracture side, site, and the mode of the treatment they received). The participants were
treated with various methods. Later, we assessed the mean shortening at the time of bone union and
overgrowth after one year of follow-up by x-ray and clinical exam.
Results: Most shaft fractures were at the dominant side (74%), mid-femur (64%), and (52%) had
undergone hip Spica. No-operatively managed cases comprised (52%). There was a significant
difference in the femoral shortening before and after one year using the X-ray parameter (p=0.000).
Moreover, a statistically significant difference (p=0.038) was seen in femoral overgrowth after one year
of follow-up by x-ray assessment only. Additionally, non-significant differences were noted between all
treatment types (hip Spica, plate and screw, elastic nail, and closed reduction + external fix) in femoral
shortening at the time of union/femoral overgrowth using both x-ray and clinical assessment following a
Conclusion: No significant difference was noticeable in the amount of bone overgrowth between
operative and non-operative managements that caused no laming or restriction of daily activities.


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