Early result of pediatric shaft femur fractures treated by hip spica cast in children upto 10 years of age

Authors

  • Khalid Muzzafar Department of Orthopaedics, Government Medical College, Jammu, Jammu and Kashmir, India
  • Rajinder Singh Department of Orthopaedics, Government Medical College, Jammu, Jammu and Kashmir, India
  • Suhail Ahmad Bhat Department of Orthopaedics, Government Medical College, Jammu, Jammu and Kashmir, India
  • Muhammad Haseeb Department of Orthopaedics, Government Medical College, Jammu, Jammu and Kashmir, India
  • Abdul Ghani Department of Orthopaedics, Government Medical College, Jammu, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20171993

Keywords:

Femur fracture, Paediatric, Skin excoriation, Spica cast

Abstract

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 study

Results: 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.

References

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

Anglen J, Choi L. Treatment options in pediatric femoral shaft fractures. J Orthop Trauma. 2005;19:724-33.

Ferguson J, Nicol RO. Early spical treatment of pediatric femoral shaft fractures. J Pediatr Orthop. 2000;20:189-92.

Dameron TB, Thompson HA. Femoral shaft fracture in children treated by closed reduction and double spica cast immobilization. J. Bone joint Surg. 1959;41B:1201-12.

Marks J. Human Biodiversity: Genes, Race, and History; Aldine De Gruyter: New York, NY, USA, 1995.

James BH, James KR. Rockwood & Wilkins’ Fractures in Children. 6th edition. Lippincott Williams & Wilkins. 2006:901.

Lascombes P, Haumont T, Journeau P. Use and abuse of flexible intramedullary nailing in children and adolescents. J Pediatr Orthop. 2006;26:827-34.

Wright JG. The treatment of femoral shaft fractures in children: a systematic overview and critical appraisal of the literature. Can J Surg. 2000;43:180-9.

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.

Corry IS, Nicol RO. Limb length after fracture of femoral shaft in children. J Pediatr Orthop. 1995;15:217-9.

Davids JR. Rotational deformity and remodeling after fracture of the femur in children. Cl in Orthop. 1994;302:27-35.

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

Mehdinasab SA, Nejad SAM, Sarrafan N. Short term outcome of treatment of femoral shaft fractures in children by two methods: Traction plus casting, versus intramedullary pin fixation – A comparative study. Pak J Med Sci. 2008;24:147-51.

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Published

2017-05-27

How to Cite

Muzzafar, K., Singh, R., Bhat, S. A., Haseeb, M., & Ghani, A. (2017). Early result of pediatric shaft femur fractures treated by hip spica cast in children upto 10 years of age. International Journal of Research in Medical Sciences, 5(6), 2430–2432. https://doi.org/10.18203/2320-6012.ijrms20171993

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Section

Original Research Articles