FRACTURE SHAFT OF FEMUR IN CHILDREN

MANAGED WITH EXTERNAL FIXATION - A COMPARATIVE STUDY OF 31 CASES

Abstract

This study was carried out to check the efficacy of external fixators as compared
to conservative management in treating fracture shaft of femur in children from 2 to 8 years.
Fracture shaft of femur in this age group are usually managed with traction for 2-3 weeks
followed by hip spicca of 3-4 weeks. It is difficult to achieve good reduction by traction. This
is not well tolerated by children. Hospital stay is prolonged. Perenial hygiene is difficult and
pressure sores are common. LLD (limb length discrepancy), knee stiffness and gait changes
are the long term complications associated with conservative management.6 We managed 31
cases of fracture shaft of femur in 30 children from the age of 2-8 years with external fixators
(ex-fix) and compared the results with 24 cases of fracture femur managed with traction and
hip spicca. Study design: Prospective study. Tertiary care hospitals of military at Muzaffarabad,
Kharian and Malir. Period: Sep 2008 to Mar 2015. Material & Methods: Informed consent was
obtained. Children from 2 to 8 years were included in this study. AO External fixator with 3.5
mm shanze screws was used with 2 screws on each side of fracture. External fixators were
removed after 8 weeks in most (>90%) of the cases. Patients were discharged on 1st postop
day. Results: Observations were made during hospital period and then fortnightly and a
minimum follow up of 6 months was done. Union was assessed clinically and on X-rays (3
surfaces union). Observations made regarding reduction achieved, complications of procedure
and compliance of children. Any LLD, knee stiffness and gait abnormality were noted during the
6 months of follow up and compared with 24 cases managed conservatively (control group).