title: Femoral shaft fractures in children--a comparison of treatment.
abstract: Between April 1986 and March 1997, 83 femoral-shaft fractures in children 4-8 years old were treated at Christian Medical College and Hospital, Ludhiana, India. Among 35 patients with a minimum of 12 months follow-up, 14 were treated with Hamilton-Russell (HR) skin traction and 14 with proximal tibial skeletal traction. The group treated with HR traction had a shorter duration of (a) hospital stay (average 16.8 days versus 29.7 days for skeletal traction, p=0.02), (b) time to fracture consolidation (average 8.8 weeks versus 10.8 weeks for skeletal traction, p=0.04), and (c) return to normal activities (average 12.2 weeks versus 17.2 weeks for skeletal traction, p=0.03). At final follow-up (minimum 1 year), there were no significant differences in functional outcomes. Conservative management is still a gold standard for treatment of closed femoral shaft fractures in children 4-8 years of age. There appears to be no advantage to skeletal traction over skin traction in this age group.
authors.affiliation: Department of Orthopedics, Christian Medical College and Hospital, Ludhiana, 141008 Punjab, India.
authors.forename: A J
authors.initials: AJ
authors.lastname: Dwyer
authors.forename: M K
authors.initials: MK
authors.lastname: Mam
authors.forename: B
authors.initials: B
authors.lastname: John
authors.forename: R A
authors.initials: RA
authors.lastname: Gosselin
mesh_terms: D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000628:therapy*; D005500:Follow-Up Studies; D017102:Fracture Healing / Q000502:physiology; D005596:Fractures, Closed / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D007194:India; D015601:Injury Severity Score; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D014143:Traction / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome