Comparison of Primary Hip Spica with Crossed Retrograde Intramedullary Rush Pins for the Management of Diaphyseal Femur Fractures in Children: A Prospective, Randomized Study

Abstract

Introduction: Femoral fractures are common in children between 2 and 12 years of age, and 75% of the lesions affect the femoral shaft. We compared primary hip spica with closed reduction and fixation with retrogradely crossed Rush pins for diaphyseal femur fracture in 25 children of age group 3 to 13 years randomly distributed in each group.

Methods: Fifty children with femoral fractures were evaluated; 25 of them underwent conservative treatment using immediate hip spica (group A) and 25 were treated with crossed retrograde Rush pins (group B). The patients ages ranged from 3 to 13 years (mean age 5.6±3.57 yrs).

Results: Mean clinico-radiological consolidation was within 15 weeks in group A and 12 weeks in group B. Mean duration of weight bearing 7 weeks in group B and 14 weeks in group A. Mean hospital stay were 8 days in group B and 4 days in group A. Mean follow up period in group A was 16 months and group B was 17 months. Complications like angulation, shortening, infection were compared. Bursitis and penetration of pins at the site of Rush pin insertion is complication associated with this method of treatment. 

Conclusions: Intra-medullary crossed Rush pinning is an effective method of paediatric diaphyseal femur fracture fixation as compared to primary hip spica in terms of early weight bearing and restoration of normal anatomy.