Keywords
Femur fractures
Paediatrics
Conservative
Categories
How to Cite
Abstract
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.
References
Beaty James H, Kasser JR. Rockwood & Wilkins’ Fractures in children. Sixth ed. Postgraduate medicine. Baltimore: Lippincott Williams & Wilkins, 2006.
Kocher MS, Sink EL, Blasier DR, Luhmann SJ, Mehlman CT, Scher DM, et al. Treatment of pediatric diaphyseal femur fractures. J Am Acad Orthop Surg. 2009 Nov;17(11):718-25. https://doi.org/10.5435/00124635-200911000-00006
Richmond J, Hunter D, Irrgang J, Jones MH, Snyder-Mackler L, Van Durme D, et al. American Academy of Orthopedics Surgeons: American Academy of Orthopaedic Surgeons clinical practice guideline on the treatment of osteoarthritis (OA) of the knee. J Bone Joint Surg Am. 2010;92(4):990-3. https://doi.org/10.2106/jbjs.i.00982
Coyte PC, Bronskill SE, Hirji ZZ, igle-Takacs G, Trerise BS, Wright JG. Economic evaluation of 2 treatments for pediatric femoral shaft fractures. Clin Orthop Relat Res. 1997;336:205–215. https://doi.org/10.1097/00003086-199703000-00029
Kasser JR. Femur fractures in children. Instr Course Lect. 1992;41:403– 408. https://dx.doi.org/10.2105%2Fajph.94.4.558
Irani RN, Nicholson JT, Chung SMK. Long term result in the treatment of femoral shaft fractures in young children by immediate spica immobilization. J Bone Joint Sur 1976;58A: 945-51.
Sugi M, Cole WG. Early plaster treatment for fractures of the femoral shaft in childhood. J Bone Joint Surg. 1987;69B :743-5. https://doi.org/10.1302/0301-620x.69b5.2824519
Epps HR, Molenaar E, O’Connor DP. Immediate single-leg spica cast for paediatric femoral diaphysis fractures. J Pediatr Orthop 2006;26:491- 496. https://doi.org/10.1097/01.bpo.0000217724.08794.e4
Mansour AA 3rd, Wilmoth JC, Mansour AS, Lovejoy SA, Mencio GA, Martus JE. Immediate spica casting of pediatric femoral fractures in the operating room versus the emergency department: comparison of reduction, complications, and hospital charges. J Pediatr Orthop 2010;30:813-817. https://doi.org/10.1097/bpo.0b013e3181fcb613
DiFazio R, Vessey J, Zurakowski D, Hresko MT, Matheney T. Incidence of skin complications and associated charges in children treated with hip spica casts for femur fractures. J Pediatr Orthop 2011;31:17-22. https://doi.org/10.1097/bpo.0b013e3182032075
Ruhullah M, Singh HR, Shah S, Shrestha D. Primary hip spica with crossed retrograde intramedullary rush pins for the management of diaphyseal femur fractures in children: a prospective, randomized study. Niger Med J. 2014;55:111-115. https://dx.doi.org/10.4103%2F0300-1652.129638
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2021 Umesh Yadav et al.
