Compared outcomes of femoral shaft fracture treatment in school-age children in Sub-Saharan Africa: Primary open reduction and intramedullary K-wire fixation versus traction followed by spica cast
Background: Elastic stable intramedullary nailing has become the treatment of choice for femur shaft fractures in school-age children in developed world. However, in the sub-Saharan Africa, this management is still challenging because of the lack of fluoroscopy in more hospitals. We performed either...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2021-01-01
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| Series: | African Journal of Paediatric Surgery |
| Subjects: | |
| Online Access: | http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2021;volume=18;issue=2;spage=79;epage=84;aulast=Yaokreh |
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| author | Jean Baptiste Yaokreh Moufidath Sounkéré-Soro Samba Tembely Yapo Guy-Serge Kouamé Audrey Helen Thomas Thierry-Hervé Odéhouri-Koudou Bertin Dibi Kouamé Ossénou Ouattara |
| author_facet | Jean Baptiste Yaokreh Moufidath Sounkéré-Soro Samba Tembely Yapo Guy-Serge Kouamé Audrey Helen Thomas Thierry-Hervé Odéhouri-Koudou Bertin Dibi Kouamé Ossénou Ouattara |
| author_sort | Jean Baptiste Yaokreh |
| collection | DOAJ |
| description | Background: Elastic stable intramedullary nailing has become the treatment of choice for femur shaft fractures in school-age children in developed world. However, in the sub-Saharan Africa, this management is still challenging because of the lack of fluoroscopy in more hospitals. We performed either primary open reduction and intramedullary K-wire fixation (PORIKF) or conservative treatment. The aim of this study was to compare the clinical and functional outcomes of these two procedures employed. Patients and Methods: This retrospective study included 62 children with 64 fractures (10 years on an average; range: 6–15 years) treating for femoral shaft fractures either by PORIKF (n = 21; 23 fractures) or skin traction followed by spica cast (n = 41) between 2008 and 2017. Outcomes were assessed using Flynn criteria. Comparisons were made by Fisher and Student's t-test with a significant P < 5%. Results: Outcomes were satisfactory in 21 cases (91%) in the PORIKF group compared with 32 (78%) in the conservative group (P = 0.3012). The average hospital stay was 18.6 days in the PORIKF group, whereas it was 20 in the conservative group (P = 0.0601). The mean time for bone union was 13.9 weeks in the PORIKF group and 13.2 weeks in the conservative group, (P = 0.4346). There was a statistically significant difference between the two groups in terms of major complications (P = 0.0177). One patient had osteomyelitis in the PORIKF group. Unacceptable shortening >2 cm was observed only in the conservative group. The average time to return to daily activities was 30 days shorter in the PORIKF group when compared to conservative group (P < 0.05). Conclusion: PORIKF provides better results than conservative treatment. Open reduction did not increase the rate of infectious complication. |
| first_indexed | 2024-12-19T10:37:30Z |
| format | Article |
| id | doaj.art-e7b178be7d4946eb9aba559ce94907a9 |
| institution | Directory Open Access Journal |
| issn | 0189-6725 |
| language | English |
| last_indexed | 2024-12-19T10:37:30Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | African Journal of Paediatric Surgery |
| spelling | doaj.art-e7b178be7d4946eb9aba559ce94907a92022-12-21T20:25:34ZengWolters Kluwer Medknow PublicationsAfrican Journal of Paediatric Surgery0189-67252021-01-01182798410.4103/ajps.AJPS_35_20Compared outcomes of femoral shaft fracture treatment in school-age children in Sub-Saharan Africa: Primary open reduction and intramedullary K-wire fixation versus traction followed by spica castJean Baptiste YaokrehMoufidath Sounkéré-SoroSamba TembelyYapo Guy-Serge KouaméAudrey Helen ThomasThierry-Hervé Odéhouri-KoudouBertin Dibi KouaméOssénou OuattaraBackground: Elastic stable intramedullary nailing has become the treatment of choice for femur shaft fractures in school-age children in developed world. However, in the sub-Saharan Africa, this management is still challenging because of the lack of fluoroscopy in more hospitals. We performed either primary open reduction and intramedullary K-wire fixation (PORIKF) or conservative treatment. The aim of this study was to compare the clinical and functional outcomes of these two procedures employed. Patients and Methods: This retrospective study included 62 children with 64 fractures (10 years on an average; range: 6–15 years) treating for femoral shaft fractures either by PORIKF (n = 21; 23 fractures) or skin traction followed by spica cast (n = 41) between 2008 and 2017. Outcomes were assessed using Flynn criteria. Comparisons were made by Fisher and Student's t-test with a significant P < 5%. Results: Outcomes were satisfactory in 21 cases (91%) in the PORIKF group compared with 32 (78%) in the conservative group (P = 0.3012). The average hospital stay was 18.6 days in the PORIKF group, whereas it was 20 in the conservative group (P = 0.0601). The mean time for bone union was 13.9 weeks in the PORIKF group and 13.2 weeks in the conservative group, (P = 0.4346). There was a statistically significant difference between the two groups in terms of major complications (P = 0.0177). One patient had osteomyelitis in the PORIKF group. Unacceptable shortening >2 cm was observed only in the conservative group. The average time to return to daily activities was 30 days shorter in the PORIKF group when compared to conservative group (P < 0.05). Conclusion: PORIKF provides better results than conservative treatment. Open reduction did not increase the rate of infectious complication.http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2021;volume=18;issue=2;spage=79;epage=84;aulast=Yaokrehchildrenfemoral shaft fracturek-wire fixationopen reductiontraction and spica cast |
| spellingShingle | Jean Baptiste Yaokreh Moufidath Sounkéré-Soro Samba Tembely Yapo Guy-Serge Kouamé Audrey Helen Thomas Thierry-Hervé Odéhouri-Koudou Bertin Dibi Kouamé Ossénou Ouattara Compared outcomes of femoral shaft fracture treatment in school-age children in Sub-Saharan Africa: Primary open reduction and intramedullary K-wire fixation versus traction followed by spica cast African Journal of Paediatric Surgery children femoral shaft fracture k-wire fixation open reduction traction and spica cast |
| title | Compared outcomes of femoral shaft fracture treatment in school-age children in Sub-Saharan Africa: Primary open reduction and intramedullary K-wire fixation versus traction followed by spica cast |
| title_full | Compared outcomes of femoral shaft fracture treatment in school-age children in Sub-Saharan Africa: Primary open reduction and intramedullary K-wire fixation versus traction followed by spica cast |
| title_fullStr | Compared outcomes of femoral shaft fracture treatment in school-age children in Sub-Saharan Africa: Primary open reduction and intramedullary K-wire fixation versus traction followed by spica cast |
| title_full_unstemmed | Compared outcomes of femoral shaft fracture treatment in school-age children in Sub-Saharan Africa: Primary open reduction and intramedullary K-wire fixation versus traction followed by spica cast |
| title_short | Compared outcomes of femoral shaft fracture treatment in school-age children in Sub-Saharan Africa: Primary open reduction and intramedullary K-wire fixation versus traction followed by spica cast |
| title_sort | compared outcomes of femoral shaft fracture treatment in school age children in sub saharan africa primary open reduction and intramedullary k wire fixation versus traction followed by spica cast |
| topic | children femoral shaft fracture k-wire fixation open reduction traction and spica cast |
| url | http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2021;volume=18;issue=2;spage=79;epage=84;aulast=Yaokreh |
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