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The use of external fixators in femur fractures in children
N de Sanctis1, A Gambardella, C Pempinello
1II Divisione di Ortopedia e Traumatologia, Ospedale Santobono, Naples, Italy.
Insights
External fixation is a safe and effective treatment for pediatric femur fractures, particularly in complex cases. This method allows children to regain independence quickly with minimal complications and good healing outcomes.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Trauma Management
Background:
- Femur fractures are common in children.
- Traditional treatments can be invasive and lead to complications.
- External fixation offers a less invasive alternative for specific pediatric fracture types.
Purpose of the Study:
- To evaluate the efficacy and safety of external fixation for treating pediatric femur fractures.
- To assess outcomes in children with complex fracture patterns requiring external fixation.
Main Methods:
- Retrospective review of 81 children (82 fractures) treated with external fixators between 1988-1993.
- External fixation applied after 24-48 hours of skin traction under general anesthesia.
- Indications included open fractures, multiple fractures, polytrauma, and unstable fractures in children over 6 years old.
Main Results:
- The external fixator was well-tolerated, with removal after 8-9 weeks.
- Fractures healed with good alignment and minimal complications.
- Few cases of superficial infections and reduced overgrowth were observed.
- Patients could achieve self-care and attend school within a week of application.
Conclusions:
- External fixation is a simple, effective, and well-tolerated treatment for pediatric femur fractures.
- It is recommended for complex cases due to its low complication rate and good functional outcomes.
- This technique facilitates early mobilization and return to daily activities.
Abstract:
Between 1988 and 1993, 81 children with 82 femur fractures were treated with external fixators at the Santobono Children's Hospital of Naples. This technique was reserved for children older than 6 years with open fractures, multiple fractures, multiple trauma, and unstable fractures. The patients were placed in skin traction on admission, and after 24-48 h, the external fixator was applied under general anesthesia. Therefore, within 1 week the children were able to take care of themselves and to attend school. The fixator was very well tolerated and was removed 8-9 weeks later. The fractures healed with good alignment, no complications with few cases of superficial infections, and less overgrowth. The use of external fixation is recommended for its simplicity and lack of complications.