Which Treatment Option for Paediatric Femoral Fractures in School-aged Children: Elastic Nail or Spica Casting?

Overview

Journal Eur J Orthop Surg Traumatol

Specialty Orthopedics

Date 2013 May 22

PMID 23689911

Citations 8

Authors

Ferhat Say

Deniz Gurler

Erkan Inkaya

Kamil Yener

Murat Bulbul

Affiliations

Soon will be listed here.

Abstract

Objective: Titanium elastic nails and immediate spica casts are treatment options for femoral fractures in school-aged children (6-12 years). This study aimed to compare the results of elastic nail and immediate spica cast methods for treating femoral fractures in school-aged children.

Materials And Methods: A retrospective evaluation was made of patients who underwent immediate spica cast (20 patients) or titanium elastic nail (22 patients) for femoral fracture. Groups were compared in terms of clinical and radiographic union, duration of hospitalisation, range of knee motion, walking independently and complications. The mean age was 9.8 ± 1.3 years for the elastic nail group and 6.4 ± 1 for the cast group. The mean follow-up period was 12.6 ± 5.2 months for the elastic nail group and 14.3 ± 6 months for the cast group.

Results: All fractures in both group were healed. Duration of hospitalisation was shorter (2.2/7.1) and range of knee motion was better (132°/129°) in the cast group. The duration for independent walking was shorter (49.2/79.8) in the nail group. These differences were significant (p < 0.001). Two superficial infections and two malalignment were detected in the nail group. Three superficial infections and four malalignment were detected in the cast group.

Conclusion: We detected that both treatment options were similar with regard to complications and results. Although the complications are similar in two treatment methods, complications of elastic nail are more challenging and may require new surgical procedure. If the elastic nail is selected, surgical complications should not be underestimated.

Citing Articles

Pediatric Femoral Shaft Fracture: An Age-Based Treatment Algorithm. Liau GZQ, Lin HY, Wang Y, Nistala KRY, Cheong CK, Hui JHP. Indian J Orthop. 2020 Oct 10;55(1):55-67. doi:10.1007/s43465-020-00281-6. eCollection 2021 Feb.

Rehm A, Ngu A, Thahir A Indian J Orthop. 2022; 56(3):517-518.

PMID: 35251518 PMC: 8854506. DOI: 10.1007/s43465-021-00453-y.

Operative Choice for Length-Unstable Femoral Shaft Fracture in School-Aged Children: Locking Plate vs. Monolateral External Fixator.

Hong P, Rai S, Tang X, Liu R, Li J Front Pediatr. 2022; 9:799487.

PMID: 35223711 PMC: 8866316. DOI: 10.3389/fped.2021.799487.

Treatment of closed femoral shaft fractures in children aged 2-10 years: a systematic review and meta-analysis.

van Cruchten S, Warmerdam E, Kempink D, de Ridder V Eur J Trauma Emerg Surg. 2021; 48(5):3409-3427.

PMID: 34338819 PMC: 9532337. DOI: 10.1007/s00068-021-01752-7.

Can Paediatric Femoral Fracture Hip Spica Application be Done in the Outpatient Setting?.

Yap S, Lee N, Ang M, Chui R, Lim K, Arjandas M Malays Orthop J. 2021; 15(1):105-112.

PMID: 33880156 PMC: 8043651. DOI: 10.5704/MOJ.2103.016.

Compared outcomes of femoral shaft fracture treatment in school-age children in Sub-Saharan Africa: Primary open reduction and intramedullary K-wire fixation versus traction followed by spica cast.

Yaokreh J, Sounkere-Soro M, Tembely S, Kouame Y, Thomas A, Odehouri-Koudou T Afr J Paediatr Surg. 2021; 18(2):79-84.

PMID: 33642403 PMC: 8232366. DOI: 10.4103/ajps.AJPS_35_20.

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