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Femur fractures in infants: a new therapeutic approach
J P Stannard1, K P Christensen, K E Wilkins
1Orthopaedic Surgery Service, Brooke Army Medical Center, Fort Sam Houston, San Antonio, Texas, USA.
Insights
The Pavlik harness effectively treats femur fractures in infants, leading to stable union within five weeks without complications. This method offers advantages over casting, including ease of application and minimal hospital stays.
Area of Science:
- Pediatric Orthopedics
- Traumatology
Background:
- Femur fractures in infants (birth to 18 months) traditionally treated with casting.
- Casting methods can present challenges in application and infant management.
Purpose of the Study:
- To evaluate the efficacy and safety of the Pavlik harness for treating femur fractures in young children.
- To compare Pavlik harness treatment with traditional casting methods for infant femur fractures.
Main Methods:
- Retrospective analysis of 14 patients (16 femur fractures) treated with a Pavlik harness.
- Fracture union, alignment, and leg-length discrepancies were assessed.
- Follow-up period ranged from 12 to 30 months (mean 20.1 months).
Main Results:
- All 16 fractures achieved stable union within 5 weeks.
- Fractures healed in good alignment with minimal leg-length discrepancies (< 1 cm).
- No adverse outcomes or complications were reported with Pavlik harness use.
Conclusions:
- The Pavlik harness is a safe and effective treatment for infant femur fractures.
- Advantages include ease of application, minimal hospitalization, cost-effectiveness, and improved infant care.
- Suitable for various fracture types and patient profiles, including younger and smaller infants.
Abstract:
Fourteen patients with 16 femur fractures sustained between birth and 18 months of age were treated with a Pavlik harness rather than traditional casting methods. All of the fractures went on to stable union within 5 weeks. Eleven fractures have been followed-up for > 12 months, with a range of 12-30 months, and a mean of 20.1 months. All of the fractures healed in good alignment, with leg-length discrepancies < 1 cm. There have been no adverse results or complications as a result of treatment with the Pavlik harness to treat femur fractures, including fractures of the proximal and middle thirds of the femur; nonambulatory infants; < 4 months old at the start of treatment or small size in selected infants up to 6 months old; and shortening of < 2 cm. Advantages of the use of the Pavlik harness include ease of application without general anesthesia, minimal hospitalization, ease of reduction, ability to adjust the harness (and therefore the fracture alignment) if the reduction is lost, minimal cost, and ease of nursing, bonding with, and changing diapers on the infant.