FUNCTIONAL OUTCOME OF FRACTURE SHAFT OF FEMUR IN CHILDREN TREATED WITH EARLY HIP SPICA
DOI:
https://doi.org/10.55519/JAMC-03-12474Keywords:
Femoral shaft fractures, Hip spica casting, Functional outcomesAbstract
Background: Femoral shaft fractures in children are a significant concern. Early hip spica casting is a treatment modality, but its functional outcomes need thorough evaluation. The objective of the study is to assess the functional outcomes of early hip spica management for femoral shaft fractures in children up to 5 years. Methods: A prospective observational study was conducted at Ayub Teaching Hospital from 15 January 2022 to 26 December 2022. Sixty-two children diagnosed with femoral shaft fractures and treated with early hip spica were enrolled. Exclusion criteria were defined. Functional outcomes, including limb shortening, malunion, skin breakdown, foot drop, and compartment syndrome, were evaluated. Follow-ups were scheduled at 6 weeks, 12 weeks, and 6 months. Data analysis was performed using SPSS software package 25. Results: Of the 45 patients analyzed, 75.56% were males. The average age was 3.56 years. Most fractures were proximal (75.55%) and resulted from motor vehicle accidents (66.67%). Limb shortening was observed in 17.77% of patients, with no significant correlation with age or fracture type. Malunion was rare (1%), and no skin breakdown, foot drop, or compartment syndrome cases were reported. Conclusion: Early hip spica casting for femoral shaft fractures in children up to 5 years is associated with minimal complications. The findings can guide clinical decisions and patient counselling.References
Palmu SA, Lohman M, Paukku RT, Peltonen JI, Nietosvaara Y. Childhood femoral fracture can lead to premature knee joint arthritis. 21-year follow-up results: a retrospective study. Acta Orthop. 2013;84(1):71-5.
Canale ST, Canale ST, Beaty JH, fracture and dislocations in children. In: editors, Campbell’s operative orthopedics. Philadelphia: Mosby Elsevier. 2008;1531-1725.
American Academy on Orthopaedics surgeon’s Pediatric thigh bone (femure) fractures internet. Last reviewed April 2010. Available from orthoinfo.aaos.org/topic.cfm?topic=a00424.
Mehmood MS, Shah S, Razzaq S, Karim A, Haq AU, Sabour A. Frequency of limb shortening in femoral shaft fractures treated by hip spica casting in children in Tertiary Care Hospital. Professional Med J. 2019;26(11):1873-7.
Mansour AA III, Wilmoth JC, Mansour AS, Lovejoy SA, Menico GA, Martus JE, et al. Immediate spica casting of pediatric femoral fractures in operating room vesus the emergency department. J Pediatr Orthop. 2010;30(8):813-7.
Soomro BA, Kella NL. Femoral shaft fracture in children treated by early spica cast. J Surg Pak (Int). 2008;13(2):103-7.
Bajwa GR, Sherazi I. Riaz T. Evaluation of results of immediate hip spica in children of 2-10 years. J Pak Orthopedic Assoc. 2012;24(6):17-21.
Jauquier N, Doerfler M, Haecker F, Hasler C, Zambelli P, Lutz N. Immediate hip spica is an effective as, but more efficient than, flexible intramedullary nailing for femoral shaft fracture in preschool children. J Children Orthop. 2010;4(5):461-5.
Hunter JB. Femoral shaft fractures in children. Injury. 2005;36(1):86-90.
Muzafar K, Bhat T, Sharma S, Bhat A, Malik I. Paediatric shaft femur fractures treated by early spica cast. Internet J Orthop Surg. 2012;19(2):123-5.
Shah FA, Durrani ZA, Khan Z, Ismatullah K, Khan H, Ali W. Outcome of femoral shaft fractures in children treated with immediate hip spica cast in emergency. Pak J Surg. 2013;29(1):52-6.
Esenyel CZ, Adanir O, Aksoy B, Esenyel M, Kara AN. Skin traction in hip spica casting for femoral fractures in children. J Orthop Sci. 2007;12(4):327-33.
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 Orthop Surg. 2007;15(1):37-40.
Haque A, Islam MS, Joarder MM. Outcome of SOF Fracture in Children Treated with Cast of the Early Hip Spica: A Prospective Study. Saudi J Med Pharm Sci. 2022;8(6):285-90.
Akinyoola AL, Orekha OO, Taiwo FO, Odunsi AO. Outcome of non-operative management of femoral shaft fractures in children. Afr J Paediatr Surg. 2011;8(1):34-9.
Dulgeroglu, A., Olcer, O., Ustaoglu, R. G., Oztekin, H. H., & Sertoz, Z. (2006). Immediate incorporated hip spica cast application for paediatric femoral fractures. Orthopaedic Proceedings, 12, pp13-16.
Siddiqui MA, Pirwani MA, Naz NASREEN, Rehman A, Soomro Y. Skin traction followed by spica cast versus early spica cast in femoral shaft fractures of children. Pak J Surg. 2008;24(1):38-41.
Singh RP, Shah RK, Dhakal A. Treatment of femoral shaft fractures in children by primary hip spica cast. J Nep Paed Soc. 2002;20:17-23.
Infante Jr 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.
Al-Mohrij S, Ahamed I, Abdul-Samad A. Management of pediatric femoral fractures using K-wires. Ann Saudi Med. 2001;21(5-6):344-6.
Additional Files
Published
Issue
Section
License
Copyright (c) 2023 Asghar Khan, Mubashir Hassan, Babar Shahzad Sadiq
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.