Related Experiment Videos
External fixation of femur fractures in children
1Department of Orthopaedics, University of Arkansas for Medical Sciences, Little Rock.
Insights
Primary external fixation and early weightbearing in pediatric femur fractures showed good outcomes. Most children returned to school quickly with full knee motion, and minimal long-term limb length discrepancy was observed.
Area of Science:
- Pediatric Orthopedics
- Traumatology
- Biomedical Engineering
Background:
- Femur fractures in children require effective treatment to ensure proper bone healing and minimize long-term complications.
- External fixation is a common method for managing pediatric femur fractures, but its optimal application, particularly with early weightbearing, needs evaluation.
Purpose of the Study:
- To evaluate the efficacy and outcomes of primary external fixation combined with early weightbearing in pediatric femur fractures.
- To assess complication rates, functional recovery, and limb length discrepancies following this treatment protocol.
Main Methods:
- A retrospective study of 42 children (44 femur fractures) treated between 1984 and 1989.
- Fractures were managed with primary external fixation, aiming for anatomical reduction.
- Early weightbearing was initiated, and follow-up included assessment of pin site issues, functional recovery, and limb length.
Main Results:
- Pin site inflammation occurred in 8.5% of pins, with 2.8% requiring antibiotics; no osteomyelitis was reported.
- Most children returned to school within 4 weeks and achieved full knee motion 6 weeks post-fixator removal.
- Long-term follow-up (≥18 months) in 16 patients revealed limb overgrowth (2-10 mm) in 38% (average 5.8 mm).
Conclusions:
- Primary external fixation with early weightbearing is a viable treatment for pediatric femur fractures, associated with low rates of serious complications.
- This approach facilitates rapid return to school and functional recovery.
- While limb overgrowth can occur, it is not universal and may be within acceptable limits for most patients.
Abstract:
Forty-two children (44 femur fractures) were treated by primary external fixation and early weightbearing (1984-1989). The fractures were reduced anatomically when possible. Average age at fracture was 9 years 7 months (range, 2 years 5 months to 17 years 8 months). Duration of external fixation averaged 70 days (range 42-117 days). Of 176 pins, 15 (8.5%) were inflamed and five (2.8%) required intravenous antibiotics; none resulted in osteomyelitis. Most patients returned to school by 4 weeks, and all had full knee motion 6 weeks after fixator removal. Of 16 patients with documented follow-up of at least 18 months, only six (38%) had overgrowth from 2 to 10 mm (average 5.8 mm).