Broken Femur

[Simon Ashley]

HI Guys
I have a very interesting client who had a compound femur fracture after being hit by a car. Age 8. He was in traction for 6 weeks and the bones have not lined up in the healing at all. The fracture was so severe that the superior bone fracture and the inferior bone fracture where lying next to each other( i hope that makes sense). Now the healing has occurred the callus has formed at 90 degrees with bone still positioned as it was after the fracture. Thus the Leg length is 2cm shorter on the affected leg. Being 8 what would you guys think about shoe lifts, bone growth and repair ( the surgeon told the family that in 3 year the bones would have lined up again?) Any thoughts?

[Nicola Tonson]

I would be asking the natropaths whether Cumfry or Silica would be of any use. As for heel lifts, I'd think that you would want to make it a lift of the whole foot, rather than just the heel, to avoid pelvic rotations. I'd also be considering whether there is a functional leg length imbalance on top of the anatomical difference which makes it even greater than 2 cms. Don't know much about heel lifts in kids though...

[Josh Laurie]

I agree with you nic, a total lift would perhaps be better suited than just a heel lift. I do have some reservations about the doctors confidence of the two bones lining back up on their own. Just because a callus has formed doesn't guarantee its all going to pull back into line does it? I would imagine it will just unite the bones in the position they are in? Either way, it certainly sounds like a case which will require some ongoing osteo supervision!!

[Nicola Tonson]

I was thinking that about the callus too - I suppose you've got to consider that the cell turnover of osteoblasts & osteoclasts might be very different in an 8 yr old to an adult...

[Nicola Tonson]

Testing Testing...

[Simon Ashley]

I was thinking that about the callus too - I suppose you've got to consider that the cell turnover of osteoblasts & osteoclasts might be very different in an 8 yr old to an adult...

Yes that is what I was thinking about the lining up of the bones also. Its a new one for me I will let you know what happens. I was thinking if anything I would do a shoe lift however would you think that a shoe lift would alter the way the bone develops and possibly hinder its growth long term. I guess I think that mechanically the bones and joint will have to readjust anyway when he has no shoes and its better for that to occur natural as a youngster now. However on the flip side of this it could create quite a bad scolosis?