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.

Skin traction in hip spica casting for femoral fractures in children

2007 ◽  
Vol 12 (4) ◽  
pp. 327-333 ◽  
Author(s):  
Cem Zeki Esenyel ◽  
Kahraman Öztürk ◽  
Oktay Adanir ◽  
Bulent Aksoy ◽  
Meltem Esenyel ◽  
...  
Keyword(s):  
Femoral Fractures ◽  
Spica Casting ◽  
Fractures In Children ◽  
Skin Traction

scholarly journals Fixator-Assisted Plating in Pediatric Supracondylar Femur Fractures

2019 ◽  
Vol 6 ◽  
pp. 2333794X1984392
Author(s):  
Noam Bor ◽  
Nimrod Rozen ◽  
Eytan Dujovny ◽  
Guy Rubin
Keyword(s):  
External Fixator ◽  
Fixation Method ◽  
Bone Lesions ◽  
Supracondylar Fractures ◽  
Anatomical Reduction ◽  
Femur Fractures ◽  
Fractures In Children ◽  
Male Patients ◽  
Supracondylar Femur Fractures

Purpose. Pediatric femoral supracondylar fractures are difficult to reduce by either closed or open reduction. The abnormal muscle forces around the knee tend to significantly displace the distal short metaphyseal fragment. We describe a novel technique utilizing the combination of a temporarily intraoperative external fixation in order to achieve and maintain the reduction followed by internal fixation. Method. Three male patients younger than 16 years of age were operated in our department. The fractures were defined as pathological in 2 patients. In order to facilitate and maintain fracture reduction, an external fixator was temporarily used intraoperatively; once the fractures were internally fixed, the fixator was removed. Results. Anatomical reduction was achieved in all patients. In an average follow-up of 2 years, all the fractures are solidly healed and the various bone lesions are healing. All patients have returned to regular physical activity. Conclusion. Difficult supracondylar femur fractures in children are easier to manipulate and reduce with the assistance of an intraoperative external fixator. Once the fracture is internally fixed and stable, the external fixator is removed.

scholarly journals Evaluation of outcome following clamp assisted mini open reduction and internal fixation with intramedullary nailing of subtrochanteric femoral fractures

2019 ◽  
Vol 5 (6) ◽  
pp. 1126
Author(s):  
Chirag G. Prajapati ◽  
Rasik B. Dabhi ◽  
Nikunj D. Maru
Keyword(s):  
Intramedullary Nailing ◽  
Femoral Fractures ◽  
The Elderly ◽  
High Energy ◽  
High Rate ◽  
Excellent Outcome ◽  
Subtrochanteric Fractures ◽  
Femur Fractures ◽  
Subtrochanteric Femur Fractures

<p class="abstract"><strong>Background:</strong> Subtrochanteric fractures of the proximal femur have been defined as the fractures extending from lesser trochanter distally for 5 cm. These fractures usually occur in two age distributions. In the elderly osteopenic population resulting from trivial trauma as fall from standing height or in the younger ones as a result of high energy trauma. Incidence has been on the rise and they comprise about 7 to 10% hip fractures and could lead quickly to large amount of blood loss and other complications.</p><p class="abstract"><strong>Methods:</strong> This is a multicentric prospective prognostic study level 1 consisting of 25 patients admitted in government civil hospital, Ahmedabad during April 2013 to May 2015 having high subtrochanteric femur fractures treated by clamp assisted reduction and intramedullary nailing. Out of these, 20 patients (80%) came for final follow up with average follow up of 11.5 months and evaluated for union, complication and functional outcome.<strong></strong></p><p class="abstract"><strong>Results:</strong> In our study final outcome is assessed based on hip outcome score (modified) based on which 85% had excellent outcome, 10% had good outcome and 5% had fair outcome with none of the patient having poor outcome.</p><p><strong>Conclusions:</strong> We found that clamp-assisted reduction and intramedullary nail fixation provides excellent reduction quality, high rate of fracture union, with no apparent increase in complications in subtrochanteric fractures of the femur. </p>

scholarly journals Randomized control trial comparing primary hip spica versus initial traction and hip spica of fracture at or below the junction of the upper and middle third of femur in children

2017 ◽  
Vol 13 (2) ◽  
pp. 80-91
Author(s):  
Pashupati Chaudhary ◽  
AR Bajracharya ◽  
A Joshi ◽  
B Sharma ◽  
R Bose ◽  
...  
Keyword(s):  
Pediatric Population ◽  
Femoral Shaft ◽  
Wound Dehiscence ◽  
P Value ◽  
Chi Square ◽  
Spica Casting ◽  
Femur Fractures ◽  
Fractures In Children ◽  
Group I ◽  
Significant Difference

Background: The debate regarding optimal management of femoral shaft fractures in the pediatric population is still far from resolved. While some consensus exists in the treatment of this injury in children younger than the age of six, opinion still widely divided in children six to 11 years.Objective: The aim of study was to compare the outcome of primary hip spica versus initial traction and hip spica of fracture of shaft of femur at or below the junction of the upper and middle third in children in terms of deformity and fracture healing.Method: A RCT study was carried out in the departments of Orthopedics, B.P.Koirala Institute of Health Sciences, Dharan, Nepal from March 2004 to January 2006. Forty five patients were included in the study in which 22 patients included in early spica casting (group I) and 23 patients in traction with spica casting (group II). The functional outcomes were assessed with Pearson’ Chi-square test, Independent samples test and union was assessed radiologically.Result: There was no statistically significant difference in time of union; all of them united in 8-10 weeks follow up. No significant overall difference in terms of deformity was noted in the two groups(p value-0.306).There was significant difference in terms of hospital stay in both the groups(p value<0.05).Conclusion: The study showed that there is significant advantage in primary hip spica cast for the treatment of isolated , closed femur fractures in children ages less than 10 years and weight less than 80 pounds(45kg) which allowed us to treat these fractures without any worry of wound dehiscence, pin site infections, avascular necrosis of the femoral head.Health Renaissance 2015;13(2): 80-91

scholarly journals The relations between the level of Mu-opioid receptor (μORs) and postoperative analgesic use in patients undergoing septoplasty: A prospective randomized controlled trial.

2020 ◽  
Author(s):  
MUZAFFER GENCER ◽  
Ayşe Yeşim Göçmen
Keyword(s):  
Postoperative Pain ◽  
Opioid Receptor ◽  
Control Group ◽  
Pain Level ◽  
Analgesic Requirement ◽  
Receptor Level ◽  
Vas Scores ◽  
Μ Opioid Receptor ◽  
Analgesic Use ◽  
Μ Opioid Receptors

Abstract Background In this study, the μ-Opioid receptor activity was examined before the septoplasty. We assessed preoperative μ-Opioid receptor activity association with postoperative pain level and second analgesic requirement in patients undergoing septoplasty. Methods In our prospective study, 120 adult patients underwent septoplasty from June 2015 to January 2019 were randomly divided into preop 2 groups. The first group (n=60) was patients given tramadol (1-2 mgr/kg) for postop analgesia, and the second group (control group) (n=60) was initially performed only fentanyl (1 µg/ kg-i.v.) in the induction. The μ-Opioid receptors activities were investigated in preoperative blood samples and compared post-op pain level and requiring time for second analgesic agent. The visual analogue score(VAS) was used to evaluate the postoperative pain degree (0 no pain,10 worst pain). Patients' post op VAS scores were evaluated upon arrival to recovery room, and at 1st, 3rd, 7th, 10th, and 24 th hours in postoperative period. Results Demographic data and perioperative variables was similar in both study group (p<0.05). There was no significant difference between the receptor levels in both two groups and the mean receptor level was 200.94 pg/ml. While the highest receptor level was 489.92 pg/ ml, the lowest receptor level was 94.56 pg/ml. In patients who used tradomal, as the levels of μ-Opioid receptors increased, VAS scores of patients and second analgesic use decreased in post-operative period. Vas scores were lower in the tramadol group compared to the control group. Patients in Tramadol group needed second pain killer later than patients in the Control group. Conclusions In this study, we revealed that postoperative pain level and second analgesic requirement decreased as μ-Opioid receptor levels increased in tramadol group.

Subtrochanteric Femur Fractures in Children

2016 ◽  
pp. 99-115
Author(s):  
Mark Seeley ◽  
Michelle S. Caird ◽  
Ying Li
Keyword(s):  
Femur Fractures ◽  
Fractures In Children ◽  
Subtrochanteric Femur Fractures

Effect of Massage With Lavender Oil on Postoperative Pain Level of Patients Who Underwent Gynecologic Surgery

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Berrak Mizrak Sahin ◽  
Ilkay Culha ◽  
Elif Gursoy ◽  
Omer Tarik Yalcin
Keyword(s):  
Postoperative Pain ◽  
Gynecologic Surgery ◽  
Pain Level ◽  
Lavender Oil ◽  
Postoperative Pain Level

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.

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