NDLI: Pediatric femoral shaft fractures: treatment strategies according to age - 13 years of experience in one medical center

Content Provider	Springer Nature : BioMed Central
Author	Sela, Yaron Hershkovich, Oded Sher-Lurie, Nir Schindler, Amos Givon, Uri
Abstract	Objective The objective of this study was to analyze our experience in treating femoral shaft fractures with different strategies, focusing on the first year after injury when the choice of method would have the greatest impact. Methods We reviewed the medical records of all children treated for femoral shaft fractures in our institution between 1997 and 2010. They were divided according to therapeutic approach: spica cast, skin traction, titanium elastic nail (TEN), external fixator, intramedullary medullary nail (IMN), and plating. Results The 212 patients included 150 boys and 62 girls (M/F ratio 2.4:1, mean age 5 years, range 0–16). The postoperative radiographic results demonstrated solid union in all patients, with no malunions. Of the 151 children in the spica cast group, 10 required re-manipulation and casting due to loss of reduction with unaccepted angulation, 10 had contact dermatitis, and 2 had fever and pressure sores. All 21 elastic nail group children underwent re-operation to remove the hardware: 3 had soft tissue irritation at the insertion points, and 3 had leg length discrepancy (LLD). Of the 14 external fixation patients, 4 had LLD, 1 had a pin tract infection, and 1 had a fracture through a pinhole after a fall. There were no complications in the 12 IMN patients, the 3 plating patients, or the 11 skin traction patients. LLD rates in the spica group were 10.5% higher compared to those in the control group (other treatment modalities) (P = .03). Conclusions TEN treatment was superior to spica casting for children who had reached an average age of 4 years.
Related Links	https://josr-online.biomedcentral.com/counter/pdf/10.1186/1749-799X-8-23.pdf
Ending Page	6
Page Count	6
Starting Page	1
File Format	HTM / HTML
DOI	10.1186/1749-799X-8-23
Journal	Journal of Orthopaedic Surgery and Research
Issue Number	1
Volume Number	8
Language	English
Publisher	BioMed Central
Publisher Date	2013-07-17
Access Restriction	Open
Subject Keyword	Orthopedics Surgical Orthopedics Femoral shaft fracture Spica Traction Casting Flexible nails Plating Antegrade trochanteric nail External fixation Children
Content Type	Text
Resource Type	Article
Subject	Surgery Orthopedics and Sports Medicine
Journal Impact Factor	2.8/2023
5-Year Journal Impact Factor	3/2023

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