[Management of femur shaft fracture in the growth age with the fixateur externe].
Non-operative management is still the treatment of choice today for femoral shaft fractures in children. Indications for operative intervention would include: - the child with multiple injuries, particularly with severe head injuries, in those patients with severe soft tissue damage associated with the fracture; in cases where the reduction is difficult to maintain, as in subtrochanteric fractures; and in children who are not suitable for management with traction. Since 1984, 16 children have had their femoral shaft fractures stabilized by external fixation (Monofixateur) here in the Trauma Department of the Hannover Medical School. The mean age of the patients was 10.3 years (seven to sixteen years). All cases were closed fractures with mild or moderate soft tissue damage. Eleven of the patients had a multiple injury, and four had subtrochanteric fractures. The external fixation remained in place for a mean of 63 days in those patients exclusively treated by this method. In four of the earlier cases there was a Schanz's screw infection and three of these required removal of the external fixation and treatment in a hip spica. After modifying the technique of Schanz's screw insertion, no further infections were seen. Fourteen of the sixteen children were reviewed, with a mean follow up of 21.7 months. None of the children who had been completely managed by this fixation had any clinically relevant malalignment. Six cases had leg lengthening of up to two centimetres. Leg length differences were seen more frequently and more severely in those cases where external fixation was delayed.
Krettek
C
C
Unfallchirurgische Klinik, Medizinische Hochschule Hannover.
Haas
N
N
Tscherne
H
H
D000293:Adolescent; D002648:Child; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000295:instrumentation*; D006801:Humans; D007870:Leg Length Inequality / Q000000981:diagnostic imaging; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011446:Prospective Studies; D011859:Radiography; D014945:Wound Healing
Versorgung der Femurschaftfraktur im Wachstumsalter mit dem Fixateur externe.