A prospective study of deep vein thrombosis of the leg in children on halo-femoral traction

Leslie, IJ; Dorgan, JC; Bentley, G.; Galloway, R.I.

doi:10.1302/0301-620x.63b2.7217136

Cited by 17 publications

(5 citation statements)

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“…However, some problems remain, principally complications associated with iliac puncture; this is associated with risks of damage to the main nerves or large blood vessels, causing paralysis or death [39,40]. Stiffness and early cervical spine degeneration were evident in almost all patients of HPT [41].…”

Section: Discussionmentioning

confidence: 99%

The radiographic, pulmonary, and clinical outcomes of patients with severe rigid spinal deformities treated via halo‐pelvic traction

Chen

Sui

Yang

et al. 2021

BMC Musculoskelet Disord

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Background The severe rigid deformity patients with pulmonary dysfunction could not tolerate complicated corrective surgery. Preoperative traction are used to reduce the curve magnitude and improve the pulmonary function before surgery, including halo-gravity traction (HGT) and halo-pelvic traction (HPT). The present study aimed to retrospectively compare the radiographic, pulmonary and clinical outcomes of preoperative HGT and HPT in severe rigid spinal deformity with respiratory dysfunction. Methods 81 cases of severe rigid kyphoscoliosis treated with preoperative traction prior to corrective surgery for spinal deformity between 2016 and 2019 were retrospectively reviewed. Two patient groups were compared, HPT group (N = 30) and HGT group (N = 51). Patient demographics, coronal and sagittal Cobb angles and correction rates, pulmonary function, traction time, osteotomy grade, and postoperative neurological complications were recorded for all cases. Results The coronal Cobb angle was corrected from 140.67 ± 2.63 to a mean of 120.17 ± 2.93° in the HGT group, and from 132.32 ± 4.96 to 87.59 ± 3.01° in the HPT group (mean corrections 15.33 ± 1.53 vs. 34.86 ± 3.11 %) (P = 0.001). The mean major sagittal curve decreased from 134.28 ± 3.77 to 113.03 ± 4.57° in the HGT group and from 129.60 ± 8.45 to 65.61 ± 7.86° in the HPT group (P < 0.001); the mean percentage corrections were 16.50 ± 2.13 and 44.09 ± 9.78 % (P < 0.001). A significant difference in the pulmonary function test results was apparent between the two groups; the mean improvements in the FVC% of the HGT and HPT groups were 6.76 ± 1.85 and 15.6 ± 3.47 % (P = 0.024). The HPT group tended to exhibit more FEV% improvement than the HGT group, but the difference was not significant (5.15 ± 2.27 vs. 11.76 ± 2.22 %, P = 0.91). Conclusions Patients with severe rigid kyphoscoliosis who underwent preoperative HPT exhibited better radiographic correction of the deformity, and pulmonary function, and required fewer osteotomies compared to the HGT group. Thus, HPT may be useful for severe rigid spinal deformity patients with pulmonary dysfunction.

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Section: Discussionmentioning

confidence: 99%

The radiographic, pulmonary, and clinical outcomes of patients with severe rigid spinal deformities treated via halo‐pelvic traction

Chen

Sui

Yang

et al. 2021

BMC Musculoskelet Disord

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“…Studies including only pediatric orthopaedic trauma patients found a VTE incidence that ranged from 0 to 387 per 10,000 children 14,36 . Our meta-analysis found that VTE incidence was much higher in orthopaedic trauma surgery (29 per 10,000 children) compared with elective orthopaedic surgery (14 per 10,000 children) 14,15,[24][25][26][27][29][30][31][32][33][34][36][37][38][39]42,43,[45][46][47][48][49] . In our study, the median age of pediatric orthopaedic VTE patients was 13 years, which is older than in previous studies investigating pediatric VTE for all hospitalized patients.…”

Section: Discussionmentioning

confidence: 75%

“…A total of 2,467,764 pediatric patients were included in the 30 studies 4,13-15,24-49 , and 3,113 were diagnosed with VTE (Table I). After applying our study exclusions, the remaining 26 studies had 850,268 orthopaedic patients with 1,108 cases of VTE.…”

Section: Resultsmentioning

confidence: 99%

Pediatric Orthopaedic Venous Thromboembolism

Mulpuri,

Sanborn,

Pradhan

et al. 2024

JBJS Open Access

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Background: There is growing evidence of increased venous thromboembolism (VTE) incidence in children with trauma or infection. The purpose of this study was to conduct a systematic review of existing literature related to VTE in the pediatric orthopaedic population, to estimate the overall incidence of VTE and identify risk factors associated with this condition. Methods: A systematic review of the available literature was performed to identify articles that described VTE in pediatric orthopaedic surgery or admission. Literature queries were performed to identify articles published from 1980 to 2021 that included patients ≤21 years of age. A stepwise search strategy of 5 electronic databases yielded 1,426 articles, which were filtered by 2 reviewers to identify 30 articles for full-text review. The primary aim was to determine the rate of VTE, and the secondary aim was to identify risk factors for VTE. The pooled incidence of VTE was estimated and reported in cases per 10,000. Studies were stratified by study size, by trauma versus elective surgery, and by orthopaedic subspecialty. Results: The 30 articles reported 3,113 VTE events in 2,467,764 pediatric patients (including those with non-orthopaedic conditions), for a pooled VTE incidence of 20 events (95% confidence interval [CI] = 10.8 to 37.2) per 10,000. Four of the studies were excluded for incomplete data or high heterogeneity. The remaining 26 studies had 850,268 orthopaedic patients with 1,108 cases of VTE, for a pooled VTE incidence of 16.6 events (95% CI = 9.1 to 30.5) per 10,000. Studies with <10,000 patients and those involving a diagnosis of trauma had the highest VTE incidence when stratification was performed. The most frequently analyzed risk factors in 15 available studies included age, sex, obesity/body mass index, type of surgery, and use of a central venous catheter. Conclusions: This systematic review indicated that the risk of VTE associated with pediatric orthopaedic surgery or admission remains low, at <17 events per 10,000 cases. However, orthopaedic surgeons should be aware of the most common risk factors associated with pediatric orthopaedic VTE and should pay special attention to traumatic etiologies, as these yielded the highest incidence. Levels of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

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“…In one small prospective study, 4 of 54 children on halo-femoral traction had DVT [14]. This is in contrast to the incidence of DVT in hospitalized adults who received no prophylaxis (from 30 % overall in high-risk patients [15,16] to 40-60 % in adults with a hip fracture or arthroplasty [17][18][19]).…”

Section: Discussionmentioning

confidence: 97%

Prevalence of deep venous thrombosis in the lower extremities of children in the intensive care unit

et al. 1996

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A prospective study of deep vein thrombosis of the leg in children on halo-femoral traction

Cited by 17 publications

References 0 publications

The radiographic, pulmonary, and clinical outcomes of patients with severe rigid spinal deformities treated via halo‐pelvic traction

The radiographic, pulmonary, and clinical outcomes of patients with severe rigid spinal deformities treated via halo‐pelvic traction

Pediatric Orthopaedic Venous Thromboembolism

Prevalence of deep venous thrombosis in the lower extremities of children in the intensive care unit

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