Femur Fracture: Functional Bracing vs. Hip Spica Cast

Author(s):  
2011 ◽  
Vol 68 (1) ◽  
pp. 9-14 ◽  
Author(s):  
Lazar Petkovic ◽  
Igor Djan ◽  
Djordje Gajdobranski ◽  
Dusan Maric ◽  
Mirjana Petkovic

Background/Aim. Femur fractures in children most often occur as a consequence of traffic accidents, during play and sport activities, and due to different pathological states. Diagnosis is rather simple and it includes physical and radiographycal examination. Femur fractures treatment in children can be operative and unoperative, depending on several facts: age, localisation and type of fracture, joint injuries of soft tissues, the presence of other injuries (in polytrauma), economical and social aspects, ect. The aim of this study was to present epidemiological characteristics of pediatric femur fractures, that is in the stage of development, including a special analysis of the used treatment techniques, as well as the comparison of the obtained data with those from the literature. Methods. The evaluation included following parameters: age, gender, cause, localisation and type of femur fracture, applied treatment and hospitalisation duration. Results. Among the presented 143 patients with femur fracture, 109 were boys and 34 were girls (3.2 : 1 ratio; p = 0.0001). Average age for both genders was 8.6 years, and no difference between boys and girls were found for the age (p = 0.758). In total, the most common fracture was diaphyseal fracture of femur in 93 (65.03%) patients. The second was proximal fracture in 30 (20.98%) patients, and the last distal fracture of the femur in 20 (13.99%) patients (p = 0.0001). Three main causes of femur fracture can be distinguished: during play and sport activities in 67 (46.8%) children, in traffic accidents in 64 (44.8%) children, and pathological fractures in 12 (8.4%) children. Inoperative treatment was applied in 82 (57.3%) patients, and operative one in 61 (42.7%) patients. The most common tretament was traction, in 71 (49.6%) patients, followed by immobilization by hip spica cast mostly in young children. Intramedullar elastic nailing was applied in 16 (11.2%) cases, and intramedullar rigid nailing (K?ntscher) in 19 (13.3%) cases. Significantlly longer hospitalization period was detected after traction (21 days) comparing to other ways of treatment, mainly operative or hip spica cast (5 to 10 days). Conclusion. In young children the standard treatment was hip spica cast after traction. Intramedullar elastic nailing is a modern trend accepted as standard in our approach to femur fracture treatment in children.


2020 ◽  
Vol 8 ◽  
Author(s):  
Umesh Yadav ◽  
Ajay Sheoran ◽  
Himanshu Bansal ◽  
Ashish Devgan ◽  
Amit Dahiya ◽  
...  

Background- Diaphyseal femur fracture in paediatric age group are common in orthopaedics with treatment options varying from conservative methods such as hip spica to operative measures such as nailing/plating. We analyzed results of patients treated conservatively in a hip spica cast. Material and Methods- 58 patients, upto 5 years of age, with shaft femur fracture managed by hip spica cast were retrospectively analysed in terms of healing clinically and radiologically and complications noted, if any. Results- Fracture healed satisfactorily in all patients. Mean age of patients affected was 3.8 years. Males were more affected and road side accident was most common etiology. Mean hospital stay was 3.4 days. Most common complication was skin breakage (27.58%) followed by cast soiling or breakage (13.79%) while shortening was seen in 3 patients (5.1%) and angulation in 2 patients (3.44%). Conclusion- Despite newer and safer implants, hip spica remains safe and cost effective method for treatment of femur fracture in children.


2004 ◽  
Vol 24 (5) ◽  
pp. 463-471 ◽  
Author(s):  
Justin Wong ◽  
Roslyn Boyd ◽  
Nigel W. Keenan ◽  
Richard Baker ◽  
Paulo Selber ◽  
...  

2002 ◽  
Vol 48 (1) ◽  
pp. 103-104 ◽  
Author(s):  
Ahmet Terzio??lu ◽  
G??rcan Aslan ◽  
Nedim Sar??fakio??lu ◽  
B??lent ????????ar

2018 ◽  
Vol 25 (05) ◽  
pp. 639-642
Author(s):  
Umar Zia Khan ◽  
Mian Amjad Ali ◽  
Faaiz Ali Shah

Objectives: To evaluate the outcome of retrograde flexible intramedullary nailsin treatment of paedriatic diaphyseal fractures in comparison with the traditional treatment ofimmediate hip spica cast. Hypothesis: We hypothesised that in children with femur fracturewho are managed with flexible intramedullary nails have better outcome in comparison tothose managed with immediate hip spica cast. Study Design: Randomized control trail. Place& Duration of Study: Lady Reading Hospital, Peshawar from June 2016 to October 2017.Methods: A group of forty-eight children aged 6-12 were randomly allocated either elasticintramedullary nail or immediate hip spica casting and were followed up to six months. Fracturealignment (coronal and sagittal angulation, leg length discrepancy), time for fracture union,recovery mile stones (time to start weight bearing with aids, independent walking, knee rangeof movement) and the presence of complications including surgical site infection were recordedand compared between two groups. Results: Children treated with elastic intramedullary nailsin comparison with those treated with immediate hip spica had early union (p<0.001), shortertime to start weight bearing with support or independently (p<0.001). Leg Length discrepancy(p<0.001), coronal and sagittal angulation (p<0.001 and p=0.02) was significantly higher in hipspica group. Difference observed between the two groups regarding knee range of movement(p=0.085) and surgical site infection (p=0.076) was not significant. Conclusion: Children aged6-12 years treated with elastic intramedullary nail for femoral diaphyseal fracture had earlierunion, reduced rate of shortening, malunion and allowed earlier rehabilitation.


2003 ◽  
Vol 16 (1) ◽  
pp. 91 ◽  
Author(s):  
Han Yong Lee ◽  
Kee Won Rhyu ◽  
Jin Young Chung ◽  
Mun Ik Sohn ◽  
Chang Ki Kim ◽  
...  

2008 ◽  
Vol 90 (8) ◽  
pp. 700-700 ◽  
Author(s):  
Inder PS Gill ◽  
Vinod Kolimarala ◽  
Richard J Montgomery
Keyword(s):  

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