Remodeling After Femoral Shaft Fractures in Children Treated by the Modified Blount Method

Malkawi, Hassan; Shannak, Akram; Hadidi, Shaher T.

doi:10.1097/01241398-198607000-00006

Cited by 50 publications

(26 citation statements)

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“…Plate osteosynthesis in isolated femoral fractures was followed by a hospital stay of 2 to 3 weeks, intramedullary nailing technique by a hospitalization of 1 to 2 weeks [10,24,33,34]. Traction with its long hospital stay proved to be a costly therapy [10,26]. In comparison, recent studies observed that treatment of isolated femur fracture with a plaster cast after reduction under anesthesia led to hospital stays of maximum 1 to 4 days [35].…”

Section: Efficiency Of the Methodsmentioning

confidence: 99%

“…Wallace et al [38] showed a correction in 85% of the patients with 10°-angulation or more and came to the conclusion that a malangulation of 25°had enough corrective potential to prevent a shift of the joint axis. Malkawi et al [26] show that malangulations in the sagittal plane have a higher remodelling potential than those in the frontal plane. Resch et al [33] showed that a deficiency in the range of motion could correct itself.…”

Section: Effectivenessmentioning

confidence: 99%

“…Resch et al [33] showed that a deficiency in the range of motion could correct itself. All authors agree that malangulations in older children cannot correct themselves [20,26,32,36,38,39]. Persisting restrictions of range of motion of the hip or knee joint, which resulted from an isolated femoral fracture, were not documented.…”

Section: Effectivenessmentioning

confidence: 99%

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External Fixation of Pediatric Femoral Shaft Fractures Treatment and Results of 121 Fractures

et al. 2000

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From 1988From to 1996 femoral shaft fractures in children were treated by external fixation. The average age was 8.4 years (range: 2 to 16 years). Thirty-three children sustained multiple injuries (27%), and 13 children had 2nd-or 3rd-degree open fractures (10.7%). This study not only analyzes the expenditure of the operation and the corresponding follow-up period, but also the complications and the final results. The average operation time was 1 h (range: 0.2 to 2.8 h). The infection rate was 6.6%. Removal of the external fixator was carried out in 35.5% of the cases on an outpatient basis. Refractures were noted in 7 cases (5.8%). The time of consolidation was 55.3 days on average (range: 36 to 94 days) and depended on the fracture type as well as on the fixator type. By using the dynamic fixation models the consolidation time could be reduced to 46 days in comparison to the stiff AO fixation models with a mean consolidation time of 68 days. Oblique and transverse fractures showed an average healing time of 54 days. Complications such as refractures, infections, delayed unions and changes in therapy mainly occurred after oblique fractures. The average follow-up time was 32 ± 18.7 months (range: 24 to 64 months). The extent of leg length differences, on average 1.3 cm, depended on the delay of surgical intervention. There was no clinical evidence of malangulation (by definition > 20°). The results do not differ from other operative procedures. The external fixator proved to be a valuable method for the treatment of pediatric femoral shaft fractures: hospital stay is reduced and full weight bearing can be achieved early. However, transverse fractures, which showed the highest complication rate, should be treated by intramedullary nailing.

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Section: Efficiency Of the Methodsmentioning

confidence: 99%

Section: Effectivenessmentioning

confidence: 99%

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External Fixation of Pediatric Femoral Shaft Fractures Treatment and Results of 121 Fractures

et al. 2000

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“…The more the angulation lies in the plane of movement of the neighbouring joint, the more significant will be the remodelling. As a consequence, in the tibia and femur angulations on the sagittal plane (antecurvatum-recurvatum) show a greater remodelling than deformities on the coronal plane (varus/valgus) [10,11].…”

Section: Discussionmentioning

confidence: 99%

Remodelling and overgrowth after conservative treatment for femoral and tibial shaft fractures in children

et al. 2008

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One thousand nine hundred and eighty-four children who had received conservative treatment for shaft (diaphyseal and metadiaphyseal) fractures of lower limbs (1162 femoral, 822 tibial fractures) at an average age of 8.5 years (range 0-14 years) were reviewed by clinical and radiographic investigations at an average follow-up of 6.6 years (1-15 years). Particularly, two main features were evaluated: remodelling of (angular and rotational) deformities and post-traumatic overgrowth. Mechanisms underlying these processes are discussed, based on a review of the literature, and parameters conditioning their evolution are analysed. Finally, criteria for an acceptable reduction (and limits for residual deformities that may be tolerated) at the time of conservative treatment are proposed.

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“…Skin or Skeletal traction with or without spica casting. [8][9][10][11][12] is much more simple and economical than operative methods. Results of the study are comparable with other similar studies.…”

Section: Discussionmentioning

confidence: 99%

Management of isolated shaft femur fractures by traction and single-leg spica cast in children

Kumar

Choudhry

2017

Int Surg J

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Background: Objective of the study was to find out the advantages of traction and single-leg spica cast in treatment of isolated femoral shaft fracture in children. Study design was Descriptive and place of the study was Darbhanga Medical College and hospital, Laheriasarai, Darbhanga, Bihar, India.Methods: 24 patients, age below 10 years, with a mean age of 5.37 years range with closed isolated femoral shaft fractures were included in the Study. Patients having compound fractures and those with associated injuries were excluded from the study. Spica cast was applied under sedation after preliminary skin traction, however immediate spica was given in children less than 2 year and those who had less than 2 cm shortening on telescopy. Follow up was done in OPD after 1,4,8,12,24 weeks with check x-rays taken at every visit.Results: 24 children were included in the study, with a mean age of 5.37 years range (2 months to 10 years). Average duration of skin traction was 14.8 days range (0-21) days. Average duration of hospital stay was 16 days range (2-22) days. Average time for fracture union was 7.4 weeks range (4-12) weeks. At final follow-up, 2 patient had Limb -Length Discrepancy (LLD) of 1.5 cm, 2 had LLD of 1 cm, 4 had LLD of 0.5cm, while 18 children had no LLD. None of the patients had short legged gait. None of the patients needed cast removal for any cast related complication.Conclusions: Traction followed by spica cast is a safe and effective method for closed fracture shaft of femur with very low risk of complication and can be done in children in less than 10 years of age.

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Remodeling After Femoral Shaft Fractures in Children Treated by the Modified Blount Method

Cited by 50 publications

References 0 publications

External Fixation of Pediatric Femoral Shaft Fractures Treatment and Results of 121 Fractures

External Fixation of Pediatric Femoral Shaft Fractures Treatment and Results of 121 Fractures

Remodelling and overgrowth after conservative treatment for femoral and tibial shaft fractures in children

Management of isolated shaft femur fractures by traction and single-leg spica cast in children

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