Comparison of Primary Hip Spica with Crossed Retrograde Intramedullary Rush Pins for the Management of Diaphyseal Femur Fractures in Children: A Prospective, Randomized Study
Keywords:Femoral fractures, Childrens, Close reduction, Hip spica, Rush Pins.
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 5.6Â±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.ÂConclusions: 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.
Flynn JM, Schwend RM. Management of pediatric femoral shaft fractures. J Am Acad Orthop Surg. 2004; 12(5):347-59.
Kirby RM, Winquist RA, Hansen ST Jr. Femoral shaft fractures in adolescents: a comparison between traction plus cast treatment and closed intramedullary nailing. J Pediatr Orthop. 1981;1(2):193-7.
Mann DC, Weddington J, Davenport K. Closed Ender nailing of femoral shaft fractures in adolescents. J Pediatr Orthop. 1986;6(6):651-5.
Ligier JN, Metaizeau JP, PrÃ©vot J, Lascombes P. Elastic stable intramedullary mailing of femoral shaft fractures in children. J Bone Joint Surg Br. 1988;70(1):74-77.
Nascimento FP, Santili C, Akkari M, et al. Short hospitalization period with elastic stable intramedullary nails in the treatment of femoral shaft fractures in school children. J Child Orthop. 2010;4(1):53-60.
Staheli LT, Sheridan GW. Early spica cast management of femoral shaft fractures in young children. A technique utilizing bilateral fixed skin traction. Clin Orthop Relat Res. 1977;(126):162-6.
Hughes BF, spousaller PD, Thorpson JD: Pediatric femur fracture: Effect of spica cast treatment on family and community. Pediatr. Orthop. 1994;15 : 457-460.
Lee SS, Mahar AT, Newton PO. Ender nail fixation of pediatric femur fractures: a biomechanical analysis. J Pediatr Orthop 2001; 21:442 - 445.
Fricka, Kevin B. MD; Mahar, Andrew T. MS; Lee, Steven S. MD; Newton, Peter O.MD.Biomechanical Analysis of Antegrade and Retrograde Flexible Intramedullary Nail Fixation of Pediatric Femoral Fractures Using a Synthetic Bone Model. Journal of Pediatric Orthopaedics. 2004;24(2):167-171.
Rathjen KE, Riccio AI, De La Garza D: Stainless steel flexible intramedullary fixation of unstable femoral shaft fractures in children. J Pediatr Orthop. 2007; 27:432â€“41.
Wall EJ, Jain V, Vora V, Mehlman CT, Crawford AH. Complications of titanium and stainless steel elastic nail fixation of pediatric femoral fractures. J Bone Joint Surg Am. 2008; 90(6):1305-13.
Cramer KE, Tornetta P 3rd, Spero CR, Alter S, Miraliakbar H, Teefey J. Ender rod fixation of femoral shaft fractures in children. Clin Orthop. 2000; 376:119-23.
Simanovsky N, Porat S, Simanovsky N, Eylon S. Close reduction and intramedullary flexible titanium nails fixation of femoral shaft fractures in children under 5 years of age. J Pediatr Orthop B. 2006; 15(4):293-7.
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