Results of traction followed by hip spica cast for closed fracture shaft of femur in children from 2 years upto 10 years of age: experience from a remote centre in North India

Authors

  • Khalid Muzzafar Department of Orthopaedics, GMC Doda, Jammu and Kashmir, India http://orcid.org/0000-0001-6571-1485
  • Arpan Bijyal Department of Orthopaedics, GMC Doda, Jammu and Kashmir, India
  • Anzar Tariq Malik Department of Orthopaedics, GMC Doda, Jammu and Kashmir, India
  • Nadeem Ali Jammu and Kashmir Health Department, Jammu and Kashmir, India
  • Abdul Ghani Department of Orthopaedics, GMC Jammu, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20223650

Keywords:

Fracture femur, Skin traction, Hip spica cast

Abstract

Background: Fracture shaft of femur is a common fracture in children, with treatment from conservative in form of skin traction to intramedullary nailing depending on age. Conservative treatment is mostly used upto six years of age, while for children more than 12 years surgery is usually preferred. We extended conservative in form of hip spica cast till 10 years of age. This study evaluates results of skin traction followed by spica cast in children upto 10 years of age.

Methods: Study was done in GMC Doda from April 2019 to March 2022. 47 patients were enrolled for study, patients were initially given skin traction to get alignment which was followed by spica cast. Patients were evaluated at 3, 6, 9 and 12 weeks, final follow up was done at 6 months.

Results: Out of 47 children, 4 patients were lost to follow up. Average age of children was 5.83 years. Mode of trauma was mostly RTA or fall from height. Average duration of traction was 9.14 days and average stay in hospital was 11.5 days. Average union time was 8.36 weeks. We had significant limb length discrepancy or angulation in 6 (13.9%) of our patients.

Conclusions: skin traction followed by spica cast gives good results in fracture shaft femur in children upto 10 years of age.

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References

Staheli LT. Fractures of the shaft of the femur. 3rd ed. Philadelphia: JB Lippincott; 1991.

John R, Sharma S, Raj GN, Singh J, C V, Rhh A, Khurana A. Current concepts in paediatric femoral shaft fractures. Open Orthop J. 2017;11:353-68.

Flynn JM, Schwend RM. Management of pediatric femoral shaft fractures. J Am Acad Orthop Surg. 2004;12(5):347-59.

Li Y, Hedequist DJ. Submuscular plating of pediatric femur fracture. J Am Acad Orthop Surg. 2012;20(9): 596-603.

Infante AF, Albert MC, Jennings WB, Lehner JT. Immediate hip spica casting for femur fractures in pediatric patients. A review of 175 patients. Clin Orthop Relat Res. 2000;(376):106-12.

Malkawi H, Shannak A, Hadidi S. Remodeling after femoral shaft fractures in children treated by the modified blount method. J Pediatr Orthop. 1986; 6(4):421-9.

Kocher MS, Sink EL, Blasier RD, Luhmann SJ, Mehlman CT, Scher DM, et al. Clinical practice guideline on treatment of pediatric diaphyseal femur fracture. J Bone Joint Surg. Am. 2010;92(8):1790-2.

Hedlund R, Lindgren U. The incidence of femoral shaft fractures in children and adolescents. J Pediatr Orthop. 1986;6(1):47-50.

Engström Z, Wolf O, Hailer YD. Epidemiology of pediatric femur fractures in children: the Swedish Fracture Register. BMC Musculoskelet Disord. 2020;21(1):796.

Caird MS, Mueller KA, Puryear A, Farley FA. Comparison plating of pediatric femoral shaft fractures. J Pediatr Orthop. 2003;23:448-52

Gross RH, Davidson RJ, Sullivan A, Peeplev EC. Cast brace management of the femoral shaft fractures in children and young adults. J Pediatr Orthop. 1983; 3:572-82.

Scott J, Wardlow O, McLaughlan J. Cast bracing in femoral shaft fractures in children: preliminary report. J Pediatr Orthop. 1981;1:99-201.

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.

Pollak AN, Cooperman DR, Thompson GH. Spica cast treatment of femoral shaft fractures in children: the prognostic value of the mechanism of injury. J Trauma. 1994;37:223-9.

Sugi M, Cole WG. Early plaster treatment for fractures of the femoral shaft in childhood. J Bone J Surg. 1987;69:743-5.

Jamaluddin M. femoral shaft fractures in children treated by early hip spica cast: Early results of prospective study. Med J Malaysia. 1995;50:72-5.

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Published

2022-12-30

How to Cite

Muzzafar, K., Bijyal, A., Malik, A. T., Ali, N., & Ghani, A. (2022). Results of traction followed by hip spica cast for closed fracture shaft of femur in children from 2 years upto 10 years of age: experience from a remote centre in North India. International Journal of Research in Medical Sciences, 11(1), 273–276. https://doi.org/10.18203/2320-6012.ijrms20223650

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Original Research Articles