Forty-five displaced femur fractures in children were treated with unilateral external fixation as a standard treatment from March 2007 to March 2009 and the last follow-up was completed in May 2012. The average age of the children at presentation was 9.93 years. Patients were followed up till union, at 1 year, and at an average of 3.5 years after fixation. The fixator was removed at an average of 12.23 weeks. Twenty-one (47%) patients had a minor complication of pin-site infection. One patient had a major complication of refracture. Treatment of uncomplicated femur fractures using an external fixator in children yields satisfactory results. Our series had a longer duration of follow-up and fewer refractures compared with other series.
1. We conclude that operative treatment is a safe and effective method of managing displaced acetabular fractures even in general orthopedic centres. 2. Time spent on a thorough study of the radiographs/CT scan for a proper preoperative plan is worthwhile and helps to outline an appropriate surgical approach and avoid complications.
We believe that it is the discretion of the surgeon to operate on the femur fracture using either of the treatment modalities. Further randomized studies need to be conducted between these two treatment modalities.
Most of the fractures in children and adolescents are treated conservatively with Plaster of Paris casts, traction. Those requiring operative intervention are managed with K wires, elastic nails and plates. External fixation is used only in open fractures, vascular injuries, polytrauma patients and burns. Methods: This is a retrospective analysis of the children records who underwent external fixation of their fractures for various reasons to find out those reasons and the bones which were fixed externally, and the results of external fixation with respect union and any complications. Results: Twenty eight patients including 19 males (68%), age between 6 and 14 yrs average age 9.64 years were treated from 2013 to 2018. A total of thirty five fractured areas were present which included ten femur fractures, nineteen tibial fractures, five patients had vascular repairs. Union rate 100%, average time to union 10.84 weeks. One refracture femur, one varus and valgus malunions of distal tibia, one grade 4 pin tract infection, on shortening and one lengthening both less than 2cms. Conclusions: External fixation in pediatric trauma is rather a compulsion than a choicest treatment modality, in view of hemodynamic instability, multiple injuries, open fractures and vascular injuries but with acceptable rates of union and complications.
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