DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20202687

A comparative study of the management of pediatric femoral shaft fractures treated conservatively with traction or spica casting

Akash Shakya, Ghanshyam Kakadiya, Yogesh Soni, Vinayak Garje

Abstract


Background: Femoral shaft fractures, though not very common, are of major concern for orthopedic surgeons. the management for infants and older children is generally universal but the young patients still offer a management dilemma.

Methods: We present a prospective study conducted at a tertiary care hospital in India of 37 children between 1 year and 6 years to compare the two conservative methods most commonly used i.e. spica casting and traction application.

Results: We found that though both the methods are similar in the time for union, shortening was better controlled with traction and angulation with spica casting. The frequency of other complications was also comparable.

Conclusions: Both the methods give acceptable results and given the feasibility of such procedures in developing countries, both may be recommended. However, the choice thus depends on the surgeon treating the patient keeping in mind the drawbacks and limitations of each.


Keywords


Pediatric, Femur, Casting, Traction, Management

Full Text:

PDF

References


Flynn JM, Skaggs D. Femoral shaft fractures. In: Flynn J.M., Skaggs D., Waters P., editors. Rockwood & Wilkins’ Fractures in Children. Philadelphia: Wolters Kluwer; 2014: 987-1026.

Loder RT, Donnell PW, Feinberg JR. Epidemiology and mechanisms of femur fractures in children. J Pediatr Orthop. 2006;26(5):561-6.

John R, Sharma S, Raj GN. Current Concepts in Paediatric Femoral Shaft Fractures. Open Orthop J. 2017;11:353-68.

Khoriati AA, Jones C, Gelfer Y, Trompeter A. The management of paediatric diaphyseal femoral fractures: a modern approach. Strategies Trauma Limb Reconstr. 2016;11(2):87-97.

Nafei A, Teichert G, Mikkelsen SS, Hvid I. Femoral shaft fractures in children: an epidemiological study in a Danish urban population, 1977-86. J Pediatr Orthop. 1992;12:499-502.

Hinton RY, Lincoln A, Crockett MM, Sponseller P, Smith G. Fractures of the femoral shaft in children. Incidence, mechanism, and sociodemographic risk factors. J Bone Joint Surg Am. 1999;81:500-9.

Lee YHD, Lim KBL, Gao GX, Mahadev A, Lam KS, Tan SB, Lee EH. Traction and spica casting for closed femoral shaft fractures in children. J Orthopaedic Surg. 2007;15(1):37-40.

Buehler KC, Thompson JD, Sponseller PD, Black BE, Buckley SL, Griffin PP. A prospective study of early spica casting outcomes in the treatment of femoral shaft fractures in children. J Pediatr Orthop. 1995;15:30-5.

Martinez AG, Carroll NC, Sarwark JF, Dias LS, Kelikian AS, Sisson GA. Femoral shaft fractures in children treated with early spica cast. J Pediatr Orthop. 1991;11:712-6.

Casas J, Moran G, Albinana J. Femoral fractures in children from 4 years to 10 years: conservative treatment. J Pediatr Orthop B. 2001;10:56-62.

Rapp M. Femoral shaft fractures in young children (<5 years of age): operative and non-operative treatments in clinical practice. Eur J Trauma Emerg Surg. 2016;42(6):719-24.

Wang CN, Feng J, Tang ZHB, Xianhong Y. Femoral Fractures in Infants: A Comparison of Bryant Traction and modified Pavlik Harness. Acta Orthop Belg. 2014;80:63-8.