Femoral-Shaft Fractures in Children

Dameron, Thomas B.; Thompson, Hugh A.

doi:10.2106/00004623-195941070-00004

Cited by 62 publications

(18 citation statements)

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“…The sex, age, side, and level of fracture in the present series correspond well with other large series (Barfod & Christensen 1958/1959, Bloch 1922, Burdick & Siris 1923, Clark 1926, Cole 1922, Conwell 1929, Dameron & Thompson 1959, David 1924, Hedberg 1944, Staheli 1967, Viljanto et al 1975). Males invariably predominate over females; the fqactures occur almost equally on the left and right sides although most studies demonstrate a slight left-sided predominance; and the middle third of the femoral shaft is always the commonest level of fracture reported, varying from 60 to 78 per cent, with the proximal third the second commonest area of involvement and the distal third the least frequent level of involvement.…”

Section: Discussionsupporting

confidence: 90%

Fractures of the Femoral Shaft in Children:The Overgrowth Phenomenon

Shapiro

1981

Acta Orthopaedica Scandinavica

148

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Section: Discussionsupporting

confidence: 90%

Fractures of the Femoral Shaft in Children:The Overgrowth Phenomenon

Shapiro

1981

Acta Orthopaedica Scandinavica

148

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“…This practice, initially controversial in children, has gained in recognition through the work of Neer and Cadman [12] and Dameron and Thompson [3]. Before applying it, one must have good knowledge of the phases of bone healing and remodelling in children [13,14].…”

Section: Discussionmentioning

confidence: 99%

“…However, the main complication of femoral shaft fracture is the leg length discrepancy, resulting from the overgrowth of the broken limb. This problem is reported by many authors whichever nonoperative treatment is used [1][2][3] and must be taken into account when choosing the therapeutic method.…”

Section: Introductionmentioning

confidence: 99%

Early reduction versus skin traction in the orthopaedic treatment of femoral shaft fractures in children under 6 years old

D’ollonne

Rubio

Leroux

et al. 2009

Journal of Children's Orthopaedics

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Background Femoral shaft fractures occur very frequently in children, and their prognosis usually is good. Nonoperative treatment is the gold standard for children under 6 years because of the excellent bony union and the remodelling qualities. Purpose The aim of this study was to compare two orthopaedic therapeutic methods: skin traction versus immediate reduction. Materials and methods The study involved 35 children, divided into two groups: in group 1, treatment consisted of skin traction for 21 days followed by hip spica casting; in group 2, an immediate reduction with early hip spica casting was performed. The ranges of motion, the delay before weight bearing, the hospitalisation duration and the required amount of painkillers were recorded. We compared initial shortening, axial, sagittal and rotational alignment, and femoral length discrepancy. We calculated the injured femoral diaphysal overgrowth and correlated it to the fracture type and location and to the initial shortening. Economical variables were also studied. Results The mean overgrowth was 8.9 mm in group 1 and 8.5 mm in group 2. Three years after the trauma, length discrepancy was 4 mm in group 1 and 1 mm in group 2. Hip spica casting leads to significant reductions in weight-bearing delay, hospitalisation duration and pain. The cost of treatment with skin traction was four times higher (24,472 euros) than that of immediate reduction (6,384 euros).Discussion Our results are in accordance with the literature. The femoral overgrowth was proportional to the initial shortening. Masculine gender, an oblique fracture and injury of the lower third of the femur were associated with the greatest femoral overgrowth. During the first year of follow-up, the femoral length discrepancy hardly varied after immediate reduction (4 mm), whereas the overgrowth reached 6 mm after skin traction. Overall, immediate hip spica casting leads to significant reductions in weightbearing delay, hospitalisation duration, complications and costs, while having similar clinical results as traction.

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“…The capsule of the acromioclavicular joint remains undisturbed. Dameron and Rockwood (10) have popularized a classification system for distal clavicular fractures in children similar to the classification system by Rockwood for acromioclavicular injuries in adults. (12) Injuries are categorized into types I to VI with increasing numbers based on the severity and direction of displacement.…”

Section: Discussionmentioning

confidence: 99%

“…However some patients will suffer persistent osseous deformity and limited function. (4,(8)(9)(10) The inferior periosteal sleeve and coracoclavicular ligaments often remain intact in distal clavicular fractures (4) and appear to provide sufficient anchorage to keep the clavicular shaft reduced in its periosteal sleeve, maintaining stable fixation during fracture healing. Based on these conditions of the soft tissue envelope, the senior author (LA) has developed an osseous suture technique to treat these fractures without the use of K-wires.…”

Section: Introductionmentioning

confidence: 99%