Estudo epidemiológico das fraturas femorais diafisárias pediátricas

Hoffmann, Cassiano Ricardo; Traldi, Eduardo Franceschini; Posser, Alexandre

doi:10.1590/s0102-36162012000200007

Cited by 4 publications

(7 citation statements)

References 9 publications

(27 reference statements)

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“…This young mean age in our study may equally reflect the absence of parental awareness or education and the tendency of children to play at home or in in-secured playing grounds unsupervised. Other authors reported higher mean ages varying between due 6.8 - 7.5 years [3, 14]. …”

Section: Discussionmentioning

confidence: 99%

“…They are more common amongst males [1, 3]. Their incidence is bimodal: first peaking between two and four years and later during adolescence [3, 4].…”

Section: Introductionmentioning

confidence: 99%

“…They are more common amongst males [1, 3]. Their incidence is bimodal: first peaking between two and four years and later during adolescence [3, 4]. The aetiologies are often age-dependent and include traffic accidents, unintentional injuries (falls and games), child abuse and pathological states [3, 4].…”

Section: Introductionmentioning

confidence: 99%

“…Due to rapid bone remodelling, most of the femoral fractures in children younger than six years can be managed conservatively by traction and plaster-cast immobilization [8]. After six years of age, femoral shaft fractures in particular, managed non-operatively may be complicated by loss of reduction, mal-union and poor school attendance [3, 8]. Thus, the best treatment option between 6 and 15 years of age is controversial [2, 8-10].…”

Section: Introductionmentioning

confidence: 99%

“…Over the last two decades, there has been a preference for surgical reduction of these fractures in children older than six years of age [6, 8]. This preference stems from early mobilization, shorter hospital stay and avoidable detrimental psychological and financial losses experienced by patients and members of their families [2, 3, 8]. Moreover, the use of flexible intramedullary nailing has revolutionized the treatment of paediatric femoral fractures by improving on cost-effective results; early union due to repeated micro-motion at fracture site, respect for the physeal plates, early ambulation, minimal scaring, easy implant removal and tremendous patient satisfaction [8, 11].…”

Section: Introductionmentioning

confidence: 99%

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A Prospective Cohort Study of the Therapeutic Patterns, Challenges and Outcomes of Paediatric Femoral Fractures in a Cameroonian Tertiary Center

Tochie¹,

Guifo²,

Yamben³

et al. 2017

TOORTHJ

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Background:Knowledge of the therapeutic patterns, challenges and outcomes of treatment of paediatric femoral fractures (PFF) helps to better choose the ideal therapeutic modality which is still controversial. However, this data is scarce in the sub-Saharan African literature.Objective:To determine the therapeutic patterns, treatment challenges and outcomes of treatment of PFF in a tertiary care centre in Cameroon.Method:We conducted a prospective cohort study of all consenting consecutive cases of femoral fractures in patients younger than 16 years managed between 2011 and 2015 at the surgical unit of Yaoundé University Teaching Hospital, Cameroon. We analysed demographic data, injury characteristics, fracture patterns, treatment details, therapeutic challenges and outcomes of treatment at 12 months using Flynn’s criteria.Results:We enrolled 30 femoral fractures from 29 children with mean age was 4.2 ± 3.3 years. The male gender, diaphyseal locations and spiral fracture lines were predominant. Main mechanisms of injury were accidental falls, road traffic accidents and game injuries. Fracture management entailed 12 tractions followed by casting, 10 casting alone, four closed reductions followed by casting, two cannulated screw fixations, one pin fixation and one external fixation. The mean duration of consolidation was 10.3 ± 3.9 weeks. The outcome was rated excellent in 28 cases. Limited resources precluded fluoroscopy use, proper anaesthetic management, early rehabilitation and patient-parent satisfaction.Conclusion:Conservative management of PFF yields a good outcome in our setting. However, an improvement in surgical, radiology and anaesthetic infrastructure is needed for optimal PFF care.

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Section: Discussionmentioning

confidence: 99%

“…They are more common amongst males [1, 3]. Their incidence is bimodal: first peaking between two and four years and later during adolescence [3, 4].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A Prospective Cohort Study of the Therapeutic Patterns, Challenges and Outcomes of Paediatric Femoral Fractures in a Cameroonian Tertiary Center

Tochie¹,

Guifo²,

Yamben³

et al. 2017

TOORTHJ

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Poor prognostic factors of femoral shaft fractures in children treated by elastic intramedullary nailing

Ulici

Odagiu

Haram

et al. 2020

SICOT-J

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Introduction: Femoral shaft fractures in pediatric patients are treated by elastic intramedullary nailing using titanium or stainless-steel nails. The elastic stable intramedullary nailing behaves as an internal splint, promoting early mobilization. This type of treatment involves a minimally invasive approach, no damage to the growth plates, and no impairment of femoral head blood supply. Purpose: The aim of our study was to identify the negative predicting factors that might lead to an increased complication rate after elastic stable intramedullary nailing of femoral shaft fractures in children. Methods: We conducted a retrospective study on 137 patients with femoral shaft fractures treated by elastic stable intramedullary nailing. Patients’ age ranged between 4 and 17 years. We used data from the medical records of the patients to evaluate postoperative complications. Plain radiographs were analyzed to determine the fracture type, fracture location, and postoperative complications such as delayed union, angular deformities, and limb length discrepancies. Multivariate analysis was conducted to identify predictors for poor outcomes. Results: Complications occurred in 29 patients (21%) and consisted of delayed union, axial deformities, or lower limb length discrepancies. In the group of patients that suffered from complications, mechanism of injury, age, and weight were significant. They were older by an average of 5 years; half of them weighed more than 50 kg and over a half were involved in a road traffic accident. Conclusions: Elastic nailing is a successful tool to treat femoral shaft fractures. Three factors were demonstrated to influence the outcome. The mechanism of injury, age > 11 years, and weight > 50 kg are the most important and are predictors for development of complications such as delayed union or deformity.

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Practice Patterns for Management of Pediatric Femur Fractures in Low- and Middle-Income Countries

Curran¹,

Albright

Ibrahim

et al. 2019

Journal of Pediatric Orthopaedics

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Background: Femoral shaft fractures in children are common in low and middle income countries. In high-income countries, patient age, fracture pattern, associated injuries, child/family socioeconomic status, and surgeon preference dictate fracture management. There is limited literature on treatment patterns for pediatric femur fractures in resource-limited settings. This study surveys surgeons from low (LIC), lower-middle (LMIC), and upper-middle income (UMIC) countries regarding treatment patterns for pediatric femur fractures. Methods: Surgeons completed an electronic survey reporting surgeon demographics and treatment preference for pediatric femur fractures. Treatment preferences and indications for treatment were separated into 4 groups: infant (0 to 6 mo); toddler (7 mo to 4 y); child (5 to 12 y); adolescent (12 to 17 y). The survey was available in English, Spanish, and French. Analysis was completed with t test and χ2 test for continuous and categorical variables, respectively, and weighted Pearson correlation (P<0.05). Results: Survey respondents consisted of 413 surgeons from 83 countries (20 LIC, 33 LMIC, 30 UMIC). The majority of respondents were fellowship trained (83%) most commonly in pediatrics (26%) and trauma (43%). Most treated >10 pediatric femur fractures per year (68%). Respondents reported treating infant femur fractures nonoperatively using Pavlik harness (19%), spica cast (60%), or traction with delayed spica cast (14%). Decreasing socioeconomic status was associated with higher nonoperative treatment rate in toddlers, children, and adolescents. Respondents commonly utilize bed rest and traction for child femur fractures in LICs (63%) and LMICs (65%) compared with UMICs (35%) (UMIC vs. LMIC P<0.001; UMIC vs. LIC P<0.001). Surgeries in children more commonly involve open reduction with internal fixation (UMIC 19%, LMIC 33%, LIC 40%; P<0.05 between UMIC-LMIC and UMIC-LIC). Conclusion: This is one of the largest surveys describing treatment patterns for pediatric femur fractures in low and middle income countries. Differences are evident including lower operative treatment rate in younger children and lower intramedullary fixation rates in older children. Future studies should investigate the value of treatment options in resource-limited settings. Level of Evidence: Level II—prospective comparative study.

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Estudo epidemiológico das fraturas femorais diafisárias pediátricas

Cited by 4 publications

References 9 publications

A Prospective Cohort Study of the Therapeutic Patterns, Challenges and Outcomes of Paediatric Femoral Fractures in a Cameroonian Tertiary Center

A Prospective Cohort Study of the Therapeutic Patterns, Challenges and Outcomes of Paediatric Femoral Fractures in a Cameroonian Tertiary Center

Poor prognostic factors of femoral shaft fractures in children treated by elastic intramedullary nailing

Practice Patterns for Management of Pediatric Femur Fractures in Low- and Middle-Income Countries

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