title: Femoral fractures in children, is early interventional treatment beneficial?
abstract: A protocol of early intervention (flexible intramedullary nails, early hip spica, and external fixation) was started in 1999 and during a 3-year period there were 25 children who sustained a femoral shaft fracture (early intervention group). These were prospectively reviewed with a minimum follow up of 24 months (Range 24-35 months). A historical control group of 41 children was used. These children were injured between February 1996 and February 1999 and were retrospectively reviewed. They had traditional in patient treatments with either Gallows or Thomas splint traction (traditional treatment group). Over the 6-year period from 1996 to 2002 there were a total of 66 femoral shaft fractures in the study that presented to our hospital. The mean length of hospital stay was 29 nights in the traditional group and 10 nights in the early intervention group. This difference is significant (p<0.001). The malunion rate was slightly higher in the early active group at radiological union but most of these remodelled over the 2 years of follow up. The protocol of early intervention used in our institution, of flexible nails, early hip spica or external fixation depended on the age of the child, and has resulted in a shorter hospital stay for the children. This has benefits for the child, the family and the hospital.
authors.affiliation: Department of Orthopaedics and Trauma, The General Infirmary at Leeds, Great George Street, Leeds, West Yorkshire LS1 3EX, United Kingdom.
authors.forename: S W
authors.initials: SW
authors.lastname: Sturdee
authors.forename: P A
authors.initials: PA
authors.lastname: Templeton
authors.forename: Z
authors.initials: Z
authors.lastname: Dahabreh
authors.forename: E
authors.initials: E
authors.lastname: Cullen
authors.forename: P V
authors.initials: PV
authors.lastname: Giannoudis
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002370:Casts, Surgical; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D016267:External Fixators; D005260:Female; D005264:Femoral Fractures / Q000191:economics / Q000628:therapy*; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary; D017721:Hospital Costs; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D010147:Pain Measurement; D017060:Patient Satisfaction; D011446:Prospective Studies; D012189:Retrospective Studies; D013165:Splints; D013997:Time Factors; D014143:Traction; D006113:United Kingdom