scholarly journals Management of isolated shaft femur fractures by traction and single-leg spica cast in children

2017 ◽  
Vol 4 (7) ◽  
pp. 2294
Author(s):  
Indrajeet Kumar ◽  
Rahul Kumar ◽  
Laljee Choudhry
Keyword(s):  
Average Duration ◽  
Femoral Shaft ◽  
Limb Length Discrepancy ◽  
Shaft Fracture ◽  
X Rays ◽  
Spica Cast ◽  
Medical College ◽  
Femur Fractures ◽  
Skin Traction

Background: Objective of the study was to find out the advantages of traction and single-leg spica cast in treatment of isolated femoral shaft fracture in children. Study design was Descriptive and place of the study was Darbhanga Medical College and hospital, Laheriasarai, Darbhanga, Bihar, India.Methods: 24 patients, age below 10 years, with a mean age of 5.37 years range with closed isolated femoral shaft fractures were included in the Study. Patients having compound fractures and those with associated injuries were excluded from the study. Spica cast was applied under sedation after preliminary skin traction, however immediate spica was given in children less than 2 year and those who had less than 2 cm shortening on telescopy. Follow up was done in OPD after 1,4,8,12,24 weeks with check x-rays taken at every visit.Results: 24 children were included in the study, with a mean age of 5.37 years range (2 months to 10 years). Average duration of skin traction was 14.8 days range (0-21) days. Average duration of hospital stay was 16 days range (2-22) days. Average time for fracture union was 7.4 weeks range (4-12) weeks. At final follow-up, 2 patient had Limb -Length Discrepancy (LLD) of 1.5 cm, 2 had LLD of 1 cm, 4 had LLD of 0.5cm, while 18 children had no LLD. None of the patients had short legged gait. None of the patients needed cast removal for any cast related complication.Conclusions: Traction followed by spica cast is a safe and effective method for closed fracture shaft of femur with very low risk of complication and can be done in children in less than 10 years of age.

scholarly journals Comparative study of day 01 spica cast versus skin traction followed by spica cast for treatment of closed femoral shaft fracture in children

2020 ◽  
Vol 2 (Number 1) ◽  
pp. 16-19
Author(s):  
Ripon Kumar Das
Keyword(s):  
Femoral Shaft ◽  
Shaft Fracture ◽  
Spica Cast ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures ◽  
Fractures In Children ◽  
Group A ◽  
Group 2 ◽  
Group B ◽  
Skin Traction

Femoral shaft fractures are among the commonest fracture of lower extremity in children and commonly require hospital admission. There are various modalities of treatments both operative and non-operative. The aim of treatment is to secure union, in good alignment with length restored and early rehabilitation. objective of this study was to compare the results of day 1 spica cast and skin traction followed by spica cast in the treatment of femoral shaft fractures in children (6 months to 10 years). A total of 64 patients with fracture shaft femur of either sex aged 6 months – 10 years with closed , isolated diaphyseal femur fracture were included in this study. Case with clinical evidence of infection, pathological fractures and multiple injuries including neurovascular injuries were excluded from the study. The patients were randomly assigned into two groups, Group -1 ( n-32) patients who underwent early spica application while Group -2 ( n-32) patients underwent skin traction in followed by spica cast. Mean age in group A was 5.06 years and 5.12 years in group B (range 6 month – 10 years). Ratio of males and female in Group A and Group B was 19:13 and 20:12 respectively. Average duration of hospital stay was 1.65 days and 11.65 days in group A and group B respectively. Average total time of spica cast application was 45.13 days 49.41 days in group A and group B patients respectively. There were no significant differences between early and delayed spica regarding the complications of treatment and functional outcome. But immediate spica decreased the hospitalization time and the cost of treatment significantly with increased availability of beds while having similar result as achieved by delayed spica application.

scholarly journals Early result of pediatric shaft femur fractures treated by hip spica cast in children upto 10 years of age

2017 ◽  
Vol 5 (6) ◽  
pp. 2430
Author(s):  
Khalid Muzzafar ◽  
Rajinder Singh ◽  
Suhail Ahmad Bhat ◽  
Muhammad Haseeb ◽  
Abdul Ghani
Keyword(s):  
Conservative Management ◽  
X Rays ◽  
Spica Cast ◽  
Average Hospital ◽  
Femur Fractures ◽  
Length Difference ◽  
Fractures In Children ◽  
Superficial Skin ◽  
Hip Spica Cast

Background: Fracture shaft of femur is constitute 1.6% paediatric fractures. Traditionally most femur fractures in children were treated conservatively, however with the coming of new implants, the indications of operating have increased. We believe guidelines based on age are from western literature where children are usually of big frame, our children being of smaller frame, the conservative management by hip spica can be extended to older children.Methods: This study was done to see the results of conservative management of femur fractures in form of hip spica and traction followed by spica in children less than 10 years of age. Patients less than 6 months of age (treated by Pavlik harness), having compound fractures and those with associated injuries were excluded from the studyResults: Follow up was done in OPD after 1,4,6,10,12 weeks with check X-rays taken after spica application and at 6, 10 ,12 weeks and at removal of spica cast. All fractures united with average union time of 7.3weeks. At final follow up of 1 year 23 patients had a limb length difference of more than 1cm. average hospital stay was 13.5 days. We had 4 cast complications in form of skin excoriation and superficial skin ulceration in 2 children and broken spica in 2 children.Conclusions: Traction followed by spica cast is safe and effective method of treating fracture of paediatric femur fractures.

scholarly journals Bryant's Traction for Neonatal Femur Fracture Occurred During Birth

2012 ◽  
Vol 7 (1) ◽  
pp. 10-12
Author(s):  
AR Mondol ◽  
ASM Jahangir Chowdhury ◽  
MS Akhter ◽  
SP Das ◽  
DK Das
Keyword(s):  
Femoral Shaft Fracture ◽  
Femur Fracture ◽  
Femoral Shaft ◽  
Limb Length Discrepancy ◽  
Shaft Fracture ◽  
Age Group ◽  
Residual Deformity ◽  
Simple Method ◽  
Femur Fractures ◽  
Acceptable Method

Femoral shaft fracture is an uncommon birth trauma. Bryant's Traction followed by spica cast is an acceptable method of treatment of femoral shaft fracture 0-18 month's age group. Here we treated 30 cases of neonatal femur fracture during birth with only Bryant's Traction of both legs for 3 weeks in hospital. We retrospectively reviewed all neonatal femur fractures occurred during birth admitted in FMCH during a two and half years period. All patients were followed up monthly for 3 months and 6 monthly for 2 years. All fractures healed satisfactorily clinically and radiographically and with no residual deformity, limb length discrepancy or functional impairment. Parents were highly satisfied with the method and its result. It is very simple method and could be safely carried out.DOI: http://dx.doi.org/10.3329/fmcj.v7i1.10290aridpur Med. Coll. J. 2012;7(1): 10-12

scholarly journals Comparative study of day 01 spica cast versus skin traction followed by spica cast for treatment of closed femoral shaft fracture in children

2020 ◽  
Vol 2 (Number 1) ◽  
pp. 16-19
Author(s):  
Ripon Kumar Das ◽  
Md Johurul Hoque ◽  
Md Emam Zamman ◽  
Fakhrul Islam
Keyword(s):  
Femoral Shaft ◽  
Shaft Fracture ◽  
Spica Cast ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures ◽  
Fractures In Children ◽  
Group A ◽  
Group 2 ◽  
Group B ◽  
Skin Traction

Femoral shaft fractures are among the commonest fracture of lower extremity in children and commonly require hospital admission. There are various modalities of treatments both operative and non-operative. The aim of treatment is to secure union, in good alignment with length restored and early rehabilitation. objective of this study was to compare the results of day 1 spica cast and skin traction followed by spica cast in the treatment of femoral shaft fractures in children (6 months to 10 years). A total of 64 patients with fracture shaft femur of either sex aged 6 months – 10 years with closed , isolated diaphyseal femur fracture were included in this study. Case with clinical evidence of infection, pathological fractures and multiple injuries including neurovascular injuries were excluded from the study. The patients were randomly assigned into two groups, Group -1 ( n-32) patients who underwent early spica application while Group -2 ( n-32) patients underwent skin traction in followed by spica cast. Mean age in group A was 5.06 years and 5.12 years in group B (range 6 month – 10 years). Ratio of males and female in Group A and Group B was 19:13 and 20:12 respectively. Average duration of hospital stay was 1.65 days and 11.65 days in group A and group B respectively. Average total time of spica cast application was 45.13 days 49.41 days in group A and group B patients respectively. There were no significant differences between early and delayed spica regarding the complications of treatment and functional outcome. But immediate spica decreased the hospitalization time and the cost of treatment significantly with increased availability of beds while having similar result as achieved by delayed spica application.

scholarly journals The Influence of Assisted Fixation on Pain Relief for Subtrochanteric Femur Fractures in Children

2020 ◽  
Author(s):  
Jin Li ◽  
Wenqi Liu ◽  
Yiyuan Chen ◽  
Yan Zhou ◽  
Jiaxin Liang ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Level ◽  
Spica Casting ◽  
Femur Fractures ◽  
Fractures In Children ◽  
Vas Scores ◽  
Subtrochanteric Femur Fractures ◽  
Skin Traction ◽  
Postoperative Pain Level

Abstract Background : Subtrochanteric femur fractures of children usually recover slower than the intertrochanteric femur fracture and tends to increas the rate of deformity. The difference among treatment options in postoperative pain level should be considered as a crucial factor while tailoring patients’ therapeutic schedules, but has not been paid enough attention to. This study aimed to evaluate and compare the postoperative pain level of hip spica casting, abduction brace and skin traction as assisted fixation to operative interventions. Methods Forty-seven children with subtrochanteric femur fractures on one side were admitted and divided into three groups according to the different assisted fixation they received. Operating time, intraoperative blood loss, follow-up time, postoperative fixation time, days in hospital, time to union, Harris scores, CHEOPS scores (before treatment, after treatment and at the last follow-up time) and VAS scores (before treatment, after treatment and at the last follow-up time) were collected. Results No significant difference of demographic characteristics data was found between the three groups before treatment(P > 0.05). After treatment and at the last follow-up time, the CHEOPS scores and the VAS scores of the three groups were all significantly lower than before(P > 0.05). But there is still no difference between the three groups(P > 0.05). Conclusion Hip spica casting, skin traction and abduction brace have the same ability to relieve the pain of subtrochanteric femur fractures in children.

scholarly journals Observational study on titanium elastic nailing in femoral shaft fractures in children

2018 ◽  
Vol 5 (1) ◽  
pp. 32
Author(s):  
Jyotirtmayee Bahinipati ◽  
R. G. Asutosh Mohapatra
Keyword(s):  
Femoral Shaft Fracture ◽  
Femoral Fractures ◽  
Femoral Shaft ◽  
Limb Length Discrepancy ◽  
Shaft Fracture ◽  
Titanium Elastic Nailing ◽  
Fractures In Children ◽  
Group 5 ◽  
One Year ◽  
Prolonged Immobilization

<p class="abstract"><strong>Background:</strong> Nowadays femoral fractures in children are more commonly managed with operative fixation rather than conservative treatment because of more rapid recovery and avoidance of prolonged immobilization. Our aim of study was to assess the outcome of titanium elastic nailing in femoral shaft fracture in children.</p><p class="abstract"><strong>Methods:</strong> Twenty five children in age group 5-15 years with femoral shaft fracture were stabilized with two titanium nails. Children were followed up for one year. The operative outcome was evaluated using criteria of Flynn. Complications associated with procedure were recorded and analyzed.<strong></strong></p><p class="abstract"><strong>Results:</strong> The final outcome was excellent in 67% (19 of 25) of patients, satisfactory in 16% (4 of 25) of patients and poor in 8% (2 of 25) of patients. Poor outcome was due to limb length discrepancy, pain in the knee and angular misalignment.</p><p class="abstract"><strong>Conclusions:</strong> We concluded that titanium elastic nailing is an ideal method of femoral shaft fixation in children.</p>

scholarly journals The Cortical Step Sign Fails to Prevent Malrotation of a Nailed Femoral Shaft Fracture: A Case Report

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Taranjit Tung ◽  
Ted Tufescu
Keyword(s):  
Case Report ◽  
Intramedullary Nailing ◽  
Femoral Shaft Fracture ◽  
Femoral Shaft ◽  
Shaft Fracture ◽  
Rotational Deformity ◽  
Femoral Nailing ◽  
Femur Fractures ◽  
Clinically Significant

Intramedullary nailing has become the treatment of choice for diaphyseal femur fractures. Malrotation is a well-recognized complication of femoral nailing. Various techniques including the cortical step sign (CSS) have been described to minimize iatrogenic rotational deformity during femoral nailing. We present a case in which the use of the CSS resulted in a clinically significant malrotation requiring revision.

scholarly journals TITANIUM ELASTIC NAIL - COMPLICATIONS IN THE TREATMENT OF PAEDIATRIC DIAPHYSEAL FRACTURE OF FEMUR§

2013 ◽  
Vol 7 (1) ◽  
pp. 12-17 ◽  
Author(s):  
Saikat Sarkar ◽  
Ranadeb Bandyopadhyay ◽  
Arindam Mukherjee
Keyword(s):  
Femoral Shaft ◽  
Shaft Fracture ◽  
Fracture Site ◽  
Diaphyseal Fracture ◽  
Entry Site ◽  
Superficial Infection ◽  
Femur Fractures ◽  
Titanium Elastic Nailing ◽  
Fractures In Children ◽  
Proximal Migration

Background: Femoral shaft fracture is the most common major paediatric orthopaedic. For generations traction and casting was the standard treatment for all femoral shaft fractures in children. Over the past two decades the advantages of fixation and rapid mobilisation have been increasingly recognised. Methods: A prospective study was conducted in five private hospitals in the district of Bankura, West Bengal over a period of two years (April 2010 to March 2012) on 70 patients with closed shaft femur fractures between 6- 14 years age of either sex. The aim was to find out the short term complications of titanium elastic nailing in diaphyseal fracture of femur in children and compare the findings of this study with pre- existing studies in this field. Results: In our study the most common complication was pain at nail entry site (60%). 5.71% had local inflammatory reaction due to nails. Superficial infection occurred in 2.85%. At the end of 1 year, 2.85% had limb length discripancies. Proximal migration occurred in 2.85%. 2.85% encountered acute reactive synovitis, 5.71% developed angulation of fracture site and 2.85% developed per operative breakage of nail. Conclusion: The treatment of paediatric shaft femur fracture has been drastically changed over the last two decades to internal fixation by elastically stable intra- medullary nail (ESIN). In our study, we encountered only a few complications most of them being minor. Most of the complications were surgical technique related and were seen at the initial phase of the learning curve.

scholarly journals Surveillance ultrasonography for conservative treatment of femoral shaft fractures in young children

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Hui Gao ◽  
Zhaoxia Wang ◽  
Yuxi Su
Keyword(s):  
Conservative Treatment ◽  
Young Children ◽  
Femoral Shaft ◽  
Preschool Age ◽  
Radiographic Evaluation ◽  
Level Of Evidence ◽  
Femur Fractures ◽  
First Choice ◽  
Significant Difference ◽  
Skin Traction

Abstract Background The treatment for femoral shaft fracture (FSF) depends on the age of the patient. While the Pavlik harness is the first choice for patients under 6 months of age, spica casting is preferred for patients over 6 months and under preschool age. Minimally-invasive surgery using elastic stable intramedullary nails is also used in some cases. Skin traction is another treatment choice for some patients who are not candidates for the above methods. This study aimed to evaluate the feasibility of surveillance ultrasonography (US) for the conservative treatment of FSFs in young children. Materials and methods This retrospective study included 92 children who were diagnosed with FSF in our hospital from April 2017 to May 2019. After applying the inclusion and exclusion criteria, they were divided into US surveillance (A) and control (B) groups. All patients received conservative treatment by skin traction. For group A, US was used to assess the femur fractures and adjust its reduction on days 1, 3, 5, 7, 10, and 14 until the fracture stabilized. For group B, the fractures were checked by radiographs on days 1, 3, 5, 7, 10, and 14 until the callus appeared. The FSF angle was measured using anteroposterior and lateral radiographs. Results All patients were followed up for 18 months. The radiographic evaluation of both groups at the final follow-up showed a significant difference in the FSF angle. The radiograph times and accumulated radiation also showed significant differences between the two groups. However, there was no significant difference in the incidence of complications. Conclusions For FSF closed reduction, surveillance US is a better option compared to radiographs in children treated by skin traction. This approach can significantly decrease exposure to X-ray radiation and improve the reduction. Level of evidence III

Sign in / Sign up

Export Citation Format

Share Document