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Randomized Controlled Trial
. 2011 Mar;12(1):45-8.
doi: 10.1007/s10195-011-0128-0. Epub 2011 Feb 22.

Titanium elastic nailing versus hip spica cast in treatment of femoral-shaft fractures in children

Hamid Reza Shemshaki  1 , Hamid Mousavi, Ghasem Salehi, Mohammad Amin Eshaghi
Affiliations
Randomized Controlled Trial

Titanium elastic nailing versus hip spica cast in treatment of femoral-shaft fractures in children

Hamid Reza Shemshaki et al. J Orthop Traumatol. 2011 Mar.

Abstract

Background: There is no consensus on treatment of closed femoral-shaft fractures in children. We compared hip spica cast with titanium elastic nailing (TEN) in the treatment of femoral-shaft fractures in children.

Materials and methods: Forty-six children, 6-12 years old, with simple femoral-shaft fractures were randomized to receive skeletal traction followed by hip spica cast (n = 23) or TEN (n = 23). Length of hospital stay, time to start walking with aids, time to start independent walking, time absent from school, parent satisfaction, and range of knee motion were compared between the two groups 6 months after injury.

Results: The two groups were similar in background characteristics. Compared with the children treated with spica cast, those treated with TEN had shorter hospital stay (P < 0.001) and took a shorter time to start walking with support or independently (P < 0.001), returned to school sooner (P < 0.001), and had higher parent satisfaction (P = 0.003). Range of knee motion was 138.7 ± 3.4° in the spica cast group and 133.5 ± 13.4° in the TEN group (P = 0.078). Three patients (13.0%) in the spica cast group compared with none in the TEN group had malunion (P = 0.117). Postoperative infection was observed in three patients (13.0%) in the TEN group.

Conclusions: The results showed significant benefits of TEN compared with traction and hip spica cast in the treatment of femoral-shaft fractures in children. Further trials with longer follow-ups and comparison of TEN with other methods, such as external fixation, in children's femoral fractures are warranted.

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References

    1. Hinton RY, Lincoln A, Crockett MM, Sponseller P, Smith G. Fractures of the femoral shaft in children. Incidence, mechanisms, and sociodemographic risk factors. J Bone Joint Surg Am. 1999;81:500–509. - PubMed
    1. Buess E, Kaelin A. One hundred pediatric femoral fractures: epidemiology, treatment attitudes, and early complications. J Pediatr Orthop B. 1998;7:186–192. doi: 10.1097/01202412-199807000-00002. - DOI - PubMed
    1. 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. doi: 10.1097/00003086-199703000-00029. - DOI - PubMed
    1. Kasser JR. Femur fractures in children. Instr Course Lect. 1992;41:403–408. - PubMed
    1. Buechsenschuetz KE, Mehlman CT, Shaw KJ, Crawford AH, Immerman EB. Femoral shaft fractures in children: traction and casting versus elastic stable intramedullary nailing. J Trauma. 2002;53:914–921. doi: 10.1097/00005373-200211000-00017. - DOI - PubMed

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