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- Treatment of Femoral Shaft Fracture with External Fixator in Children
- Phil Hyun Chung, Suk Gang, Dong Ju Chae, Jong Pil Kim, Sung Pock Park
- J Korean Soc Fract 2002;15(3):421-426. Published online July 31, 2002
- DOI: https://doi.org/10.12671/jksf.2002.15.3.421
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Abstract
PDF - PURPOSE
Children with femoral shaft fractures in association with other injuries such as head injuries, abdominal injuries, open fractures, multiple fractures, or unstable displaced fractures require operative treatment rather than being treated in conservative methods. In this study, we compare the surgical result of femoral shaft fracture using external fixator in children, and evaluate the complications and the related factors as well as the advantage over the other management described in the literature.
MATERIALS AND METHODS
We reviewed 15 cases of femoral shaft fractures in children admitted between May, 1995 and May, 2000. The mean age was 8 years and 2months old (range: 6-12 year-old, 9 boys, 6 girls). All the evaluations were based on the postoperative radiologic studying and clinical findings. In the radiologic evaluations, bony union time, angular deformity, and leg length discrepancy in both sagittal and coronal plane were evaluated, and in the clinical evaluations, we analyzed the duration of external fixation, hospital day, range of motion in both hip and knee joint, and post-operative complications.
RESULTS
The average bony union time based on the radiologic studying was 10.9 weeks (ranging from 7 to 24 weeks). Angular deformity at the fracture site was less than 5 degrees and no rotational deformity was found in all 15 cases. The average length of overriding fracture fragment was 11.7 mm (ranging from 10 to 15 mm) and average leg length discrepancy was 2.1 mm (ranging from -3 to +10mm). Duration of external fixation averaged 12.1 weeks (ranging from 9 to 24 weeks) and average hospital day was 29.4 day (ranging from 21 to 48 day). None of the patient had limitation in hip or knee joint movement. There were 1 case of refracture (case of pathologic fracture) and 4 cases of pin tract infection(superficial infection).
CONCLUSION
At our institution, we observed average overgrowth of 2.1 mm and no severe complications excepts in 1 case of refracture due to pathologic fracture. Thus we concluded that closed reduction and external fixation is effective in treating open, or unstable displaced fracture of femoral shaft with other associated injuries in pediatric population, and it is also believed to be effective means in treating closed femoral fractures.
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- Treatment of Intertrochanteric Fractures of Femur Using Intramedullary Hip-Screw
- Phil Hyun Chung, Chung Soo Hwang, Suk Gang, Dong Ju Chae, Jong Pil Kim, Joon Han Kim
- J Korean Soc Fract 2001;14(4):575-583. Published online October 31, 2001
- DOI: https://doi.org/10.12671/jksf.2001.14.4.575
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Abstract
PDF
- PURPOSE
We analyze the results of the treatment of intertrochanteric fractures by using intramedullary hip screw.
MATERIALS AND METHODS
We reviewed 34 patients of intertrochanteric fracture who were treated by using of intramedullary hip screw from March 1998 to February 2000, and we classified the fractures by Evans system. 26 cases were treated by closed reduction and internal fixation; 8 cases were by open reduction and internal fixation. We analyzed fracture figure and stability, amount of sliding of lag screw, the change of femur neck-shaft angle, postoperative activity and postoperative complication RESULTS: Bony union was obtained in average 14.3 weeks. Gap of fracture site was formed in 2 cases and crack on entry area of nail was formed in 1 case. Postoperative wound infection occurred in laces and delayed union occurred in 1 case. The change of femur neck-shaft angle showed an average decrease 1.7 degree in stable fractures, 3.5 degree in unstable fractures. Lag screw was sided an average 1.0 mm in stable fractures, 2.6 mm in unstable fractures. Postoperative mobility were analyzed by score of Parker and Palmer, and showing from 7.6 score pretrauma to 3.37 score postoperation in 1 month, 5.0 score postoperation in 3 months, 7.48 score postoperation in 6 months and 7.5 score postoperation in one year.
CONCLUSION
Intramedullary hip screw in intertrochanteric fractures reduced the collapse by processing union of fracture site due to the less decreases of femur neck shaft angle and the shortening by sliding of lag screw
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