Pediatric Femoral Fracture : Factors Affected Acute and Late Complication in Buriram Hospital
Article Sidebar
Main Article Content
Abstract
Background: Femoral fracture is the major pediatric injury of orthopedic surgery department. Management depends on co-morbidity, fracture characteristic, age and socioeconomic factor.
Objective: To study complication rate and associated factors in pediatric femoral fracture cases in both acute and late period.
Setting: Orthopedic Surgery Department, Buriram hospital.
Research design: Descriptive retrospective Study
Method: The medical records of children admitted with femoral fractures in Buriram hospital during October 2004 - September 2007 were reviewed. Demographic and clinical data such as age, sex, cause of injury, treatment, length of stay, acute and late complication including mortality rate were collected and analyzed by descriptive statistics and Chi-square test.
Results: The 218 medical records were reviewed. Six patients died and from 212 of treated patients; 78 cases (36.79%) were applied hip spica and 134 cases (63.21%) underwent operative fixation. Acute and late complication rate of pediatric femoral fractures were 16.98% and 15.76% respectively. There was no acute minor complication found in patients applied hip spica whereas operative fixation cases found 1.4% of the complication. Acute major complication was found 11% and 18.7% in hip spica applied group and operative fixation group respectively. There was no statistically different of late complication rate between hip spica applied group 16.4% and operative fixation group 6.2%. However significant difference in length of stay between conservative treatment (hip spica) and operative treatment (2.54 days and 6.20 days respectively) was found (p < 0.05). The leg's length discrepancy (> 2 cm) complication was found in 7.84% of the conservative treatment (hip spica) group.
Conclusion: Acute and late complication of pediatric femoral fracture cases in Buriram hospital were 16.98 % and 15.76 % respectively. There was no relevant factor (age, sex or cause of injury) associated with the femoral fracture complication. Length of stay in hip spica applied patients was less than those of operative fixation group. However leg's length discrepancy was found ๒ hip spica applied group (7.84%).
Key words: Femoral fracture, pediatric, hip spica, operative fixation, complications, factors
Article Details
References
2. Anglen JO, Choi L. Treatment options in pediatric femoral shaft fractures. J Orthop Trauma 2005;19(10):724-33.
3. Esenyel CZ, Ozturk K, Adanir O, Aksoy B, Esenyel M, Kara AN. Skin traction in hip spica casting for femoral fractures in children. J Orthop Sci 2007;12(4):327-33.
4. Flynn JM, Schwend RM. Management of pediatric femoral shaft fractures. J Am Acad Orthop Surg 2004;12(5):347-59.
5. Maier M, Maier-Heidkamp P, Lehnert M, Wirbel R, Marzi I. Results of femoral shaft fractures in childhood in relation to different treatment modalities. Unfallchirurg 2003;106(1):48-54.
6. Schonk JW. Comparative follow-up study of conservative and surgical treatment of femoral shaft fractures in children. Arch Chir Neerl 1978;30(4):231-8.
7. Beaty JH. Operative treatment of femoral shaft fractures in children and adolescents. Clin Orthop Relat Res 2005;434:114-22
.
8. Poolman RW, Kocher MS, Bhandari M. Pediatric femoral fractures : a systematic review of 2422 cases. J Orthop Trauma 2006;20(9):648-54.
9. Leet AI, Pichard CP, Ain MC. Surgical treatment of femoral fractures in obese children : dose excessive body weight increase the rate of complications? J Bone Joint Surg Am 2005;87(12):2609-13.
10. Feld C, Gotzen L, Hannich T. Pediatric femoral shaft fracture in the 6-14 year age group. A retrospective therapy comparison between conservative treatment, plate osteosynthesis and external stabilization. Unfallchirurg 1993;96(3):169-74.
11. Wilson NC, Stott NS. Paediatric femoral fractures : factors influencing length of stay and readmission rate. Injury 200;38(8):931-6.
12. Widjaja AB, Eng K, Griffiths J. Complications of internal fixation in paediatric fractures. ANZ J Surg. 2007;77(10):873-6.
