Human growth hormone therapy linked with pediatric tibial physeal avulsion fractures
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Key takeaways:
- Human growth hormone therapy was associated with increased risk for proximal tibial physeal avulsion fractures.
- Surgeons should keep this risk in mind when counseling pediatric patients and their families.
According to published results, recombinant human growth hormone therapy was associated with increased risk for proximal tibial physeal avulsion fractures in pediatric patients.
Samuel A. Beber, MSc, and colleagues at Hospital for Special Surgery performed a case-control study of 132 pediatric patients (mean age, 13 years) who reported to a single institution for a tibial fracture between Feb. 1, 2016, and May 4, 2023. Researchers analyzed two 1:1 matched cohorts: 66 patients with proximal tibial physeal avulsion fractures and a control group of 66 patients with midshaft tibial fractures.
Researchers found 11% of patients (n = 7) with physeal avulsion fractures were receiving recombinant human growth hormone (rhGh) therapy, whereas no patients with midshaft fractures were receiving rhGH therapy at the time of injury (OR = 15; 95% CI, 1.8-1,946).
Researchers found no significant difference in the proportion of sports-related injuries between patients with physeal avulsion fractures and patients with midshaft fractures (70% vs. 67%; OR = 1.15; 95% CI, 0.55-2.39). They also found similar rates of required surgery for patients with physeal avulsion fractures who received rhGH therapy vs. those who did not receive rhGH therapy (43% vs. 41%).
“Published literature describes slipped capital femoral epiphysis as a complication of rhGH therapy that may be related to decreased physeal strength,” the researchers wrote. “In an environment of shared decision-making, keeping this risk in mind enables providers, young patients and their families to make more informed decisions about initiating or continuing growth hormone therapy and whether activity modification may be warranted during treatment.”
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