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Abstract
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BACKGROUND: Bilateral femur fractures are rare in the pediatric population with few cases reported in the literature. The purpose of this study was to review our institutional experience with a case series of simultaneous bilateral femur fractures to highlight the presentation, treatment, and outcomes of these rare injuries as well as perform a preliminary comparison to similar unilateral femur fractures in order to identify any clinically relevant differences that may guide future management.
Methods: We undertook a retrospective chart review of patients who had presented with simultaneous bilateral femur fractures between 2007 and 2017 with a minimum of 1-year of follow-up. Descriptive information was provided about the case series of bilateral femur fracture patients with subsequent further analysis comparing unilateral and bilateral femur fractures.
Results: Eight patients (7 males, 1 female) were identified after chart review. Mean age at the time of injury was 11 years (8 to 15 years). Mechanism of injury was high energy trauma in 7 of 8 patients. Six of 8 patients presented with at least one significant associated injury. All patients underwent operative fixation bilaterally. Average length of stay was 12 days (range 4-27 days). Four patients required admission to inpatient rehab facility. Complete healing occurred in all patients. One patient experienced unilateral genu valgum deformity treated successfully with growth modulation. Another patient experienced a unilateral bony bar of approximately 20% of the physis which did not result in angular deformity or limb length discrepancy. After comparing to a matched unilateral femur fracture cohort, we found that patients who sustained bilateral femur fractures had a significantly higher number of associated injuries as well as greater length of stay (p<0.05). There was no statistical difference in complications.
Conclusions: Our case series illustrates the presentations and outcomes of this rare injury pattern in children along with a few potential differences that distinguish bilateral femur fractures from unilateral fractures. These results may help guide healthcare personnel in making management decisions regarding this rare injury.
Level of Evidence: IV.
Language: en |