Staging of healing of femoral fractures in children.

Although the rate of fracture healing has been studied in adults, little such work has been done in children. The authors' objective was to develop staging criteria for assessing callus formation in fractures in children and to determine the relation between the age and sex of the patient and callus formation. They studied callus formation in healing fractures of the femoral diaphysis in 25 patients, 15 boys and 10 girls, ranging in age from birth to 14 years. The patients were selected on a random basis from children presenting with femoral fractures (and no other injuries) to a tertiary-care pediatric hospital in Winnipeg over the period 1988 to 1991. The following staging criteria were developed from other examples of femoral fracture: stage 1, earliest radiographically visible calcification of the callus; stage 2, callus completely bridging the fracture site; and stage 3, mature callus. For the patients in the study, the average times to reach stages 1, 2 and 3 were 11.7, 18.7 and 55.3 days respectively. The sex of the patient had no effect on callus formation. The final stage of healing appeared to take longer with increasing patient age, although this observation was not statistically significant.