Suitability of skin traction combined with braces for treating femoral shaft fractures in 3–5 years old children

Abstract Background In children aged 3–5 years, femoral fractures are common and are frequently treated using flexible intramedullary nails (FIN) or spica casting. Recently, more surgeons have been relying on FIN surgery because of the high rate of complications associated with spica casts, such as...

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Main Authors: Menglei Wang, Yuxi Su
Format: Article
Language:English
Published: BMC 2023-01-01
Series:Journal of Orthopaedic Surgery and Research
Subjects:
Online Access:https://doi.org/10.1186/s13018-023-03547-5
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author Menglei Wang
Yuxi Su
author_facet Menglei Wang
Yuxi Su
author_sort Menglei Wang
collection DOAJ
description Abstract Background In children aged 3–5 years, femoral fractures are common and are frequently treated using flexible intramedullary nails (FIN) or spica casting. Recently, more surgeons have been relying on FIN surgery because of the high rate of complications associated with spica casts, such as skin irritation and re-adjustment surgery. We aimed to evaluate the effect of skin traction combined with braces in 3–5 years old children at our hospital. Methods We retrospectively analyzed 125 children aged 3–5 years with femoral shaft fractures treated at our hospital between January 2010 and December 2020. We assigned 68 patients who underwent FIN surgery to Group A and 57 patients treated with skin traction and braces to Group B. Comparative analysis included the children’s age, sex, side of the affected limb, cause of fracture, function of the knee joint, healing time of the fracture, duration of hospitalization, cost of hospitalization, and complications. The complications evaluated included joint dysfunction, pain, infection, pressure ulcers, angular deformities, limb length differences, re-fractures, nonunion fractures, and delayed union. Results There were significant differences in and hospital costs (p = 0.001). Conversely, no statistically significant differences were observed in sex (p = 0.858), injury type (p = 0.804), age (p = 0.231), hospitalization time (p = 0.071), bone healing time (p = 0.212), and complications. Pressure ulcers, nonunion fractures, and delayed union did not occur in both groups. Conclusion Both methods had similar therapeutic effects and postoperative complications in children aged 3–5 years with femoral shaft fractures. Therefore, skin traction combined with braces is recommended for this population and for patients hospitalized in institutions where several beds are available, with a consequent possibility of prolonged hospitalization. Level of Evidence: IV.
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spelling doaj.art-c05d4d9ea4824d58863add04285de80b2023-01-29T12:17:34ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2023-01-011811810.1186/s13018-023-03547-5Suitability of skin traction combined with braces for treating femoral shaft fractures in 3–5 years old childrenMenglei Wang0Yuxi Su1Department of Orthopedics, Chongqing Key Laboratory of Pediatrics; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation base of Child development and Critical Disorders, Children’s Hospital of Chongqing Medical UniversityDepartment of Orthopedics, Chongqing Key Laboratory of Pediatrics; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation base of Child development and Critical Disorders, Children’s Hospital of Chongqing Medical UniversityAbstract Background In children aged 3–5 years, femoral fractures are common and are frequently treated using flexible intramedullary nails (FIN) or spica casting. Recently, more surgeons have been relying on FIN surgery because of the high rate of complications associated with spica casts, such as skin irritation and re-adjustment surgery. We aimed to evaluate the effect of skin traction combined with braces in 3–5 years old children at our hospital. Methods We retrospectively analyzed 125 children aged 3–5 years with femoral shaft fractures treated at our hospital between January 2010 and December 2020. We assigned 68 patients who underwent FIN surgery to Group A and 57 patients treated with skin traction and braces to Group B. Comparative analysis included the children’s age, sex, side of the affected limb, cause of fracture, function of the knee joint, healing time of the fracture, duration of hospitalization, cost of hospitalization, and complications. The complications evaluated included joint dysfunction, pain, infection, pressure ulcers, angular deformities, limb length differences, re-fractures, nonunion fractures, and delayed union. Results There were significant differences in and hospital costs (p = 0.001). Conversely, no statistically significant differences were observed in sex (p = 0.858), injury type (p = 0.804), age (p = 0.231), hospitalization time (p = 0.071), bone healing time (p = 0.212), and complications. Pressure ulcers, nonunion fractures, and delayed union did not occur in both groups. Conclusion Both methods had similar therapeutic effects and postoperative complications in children aged 3–5 years with femoral shaft fractures. Therefore, skin traction combined with braces is recommended for this population and for patients hospitalized in institutions where several beds are available, with a consequent possibility of prolonged hospitalization. Level of Evidence: IV.https://doi.org/10.1186/s13018-023-03547-5Skin tractionBracesFemoral shaft fracturesChildrenPreschool
spellingShingle Menglei Wang
Yuxi Su
Suitability of skin traction combined with braces for treating femoral shaft fractures in 3–5 years old children
Journal of Orthopaedic Surgery and Research
Skin traction
Braces
Femoral shaft fractures
Children
Preschool
title Suitability of skin traction combined with braces for treating femoral shaft fractures in 3–5 years old children
title_full Suitability of skin traction combined with braces for treating femoral shaft fractures in 3–5 years old children
title_fullStr Suitability of skin traction combined with braces for treating femoral shaft fractures in 3–5 years old children
title_full_unstemmed Suitability of skin traction combined with braces for treating femoral shaft fractures in 3–5 years old children
title_short Suitability of skin traction combined with braces for treating femoral shaft fractures in 3–5 years old children
title_sort suitability of skin traction combined with braces for treating femoral shaft fractures in 3 5 years old children
topic Skin traction
Braces
Femoral shaft fractures
Children
Preschool
url https://doi.org/10.1186/s13018-023-03547-5
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AT yuxisu suitabilityofskintractioncombinedwithbracesfortreatingfemoralshaftfracturesin35yearsoldchildren