Comparison of external fixation and pelvipedal cast treatments in closed femur diaphysis fractures in children

Cumhur KESEMENLİ; Mehmet SUBASİ; Turgut KİRKGOZ; Serdar NECMİOGLU; Ahmet KAPUKAYA

Article Details

Comparison of external fixation and pelvipedal cast treatments in closed femur diaphysis fractures in children

Authors:

Cumhur KESEMENLİ | Mehmet SUBASİ | Turgut KİRKGOZ | Serdar NECMİOGLU | Ahmet KAPUKAYA

Publisher:

Turkish Association of Orthopaedics and Traumatology

Journal:

Acta Orthopaedica et Traumatologica Turcica 2000 Vol.34 Issue 1, pp.40-44

Document Type:

Article

Publication Date:

9/2006

Document Language:

English

Document ID (Org No.):

2000813358

Frequency:

Bimonthly

eISSN:

1017-995X

pISSN:

1017-995X

Keywords:

Abstract:

 

Objectives: We compared the results of treatment with external fixation and a spica cast in children with closed femoral fractures.
Methods: A total of 157 children with closed femoral fractures were treated using external fixation (n=57; 36.3%; mean age 6 years; age range 4-12 years) and a spica cast (n=100; 63.6%; mean age 6.1 years; age range 2-12 years) following 90-90 traction. Patients were followed-up for a mean duration of 18 months (range 9-36 months).
Results: Mean length of hospitalization and treatment was eight days (range 5-15 days) and 51 days (range 35-79 days) in the external fixation group, respectively. Hospital stay and treatment duration were longer in patients treated with a spica cast plaster, being 15.7 days (range 6-22 days) and 63.3 days (range 45-78 days), respectively. Pin-tract infection developed in 5.3% (n=3) in the former and in 6% (n=6) in the latter. Development of pressure sores was noted on the back and perineal regions in 25 patients (25%) in the conservative treatment group. Average number of radiographic examinations during hospitalization was greater in patients undergoing conservative treatment, being five times (range 5-8 times) versus two times (range 2-4 times). Conservatively treated patients exhibited a mean increase of 0.6 cm (range 0.3-1.7) in length, while no increases were observed in the latter group.
Conclusion:The use of external fixation seems to be an appropriate choice in children with closed femoral fractures especially in clinics experiencing limited bed-size and workforce shortage.

 

Amaç: Kapalı çocuk femur kırıklarında eksternal fiksatör ve pelvipedal alçı ile tedavi edilen çocuk olguların tedavi sonuçları karşılaştırıldı.
Çalışma planı: Kapalı femur kırığı nedeniyle başvuran 157 hastanın 57’si (%36.3; yaş ort. 6; yaş dağılımı 4-12) eksternal fiksatör, 100’ü (%63.6; yaş ort. 6.1; yaş dağılımı 2-12) 90-90 traksiyon sonrası pelvipedal alçı kombinasyonu ile tedavi edildi. Hastalar ortalama 18 ay (9-36 ay) takip edildi.
Sonuçlar: Eksternal fiksatör kullanılan olgularda hastanede kalış süresi ortalama sekiz gün (5-15 gün); tedavi süresi ortalama 51 gün (35-79 gün); pelvipedal alçı uygulanan hastalarda hastanede kalış süresi ortalama 15.7 gün (6-22 gün), tedavi süresi ise 63.3 gün (45-78 gün) bulundu. İki grupta tel dibi enfeksiyon oranları sırasıyla %5.3 (n=3) ve %6 (n=6) idi. Konservatif tedavi uygulanan olguların 25’inde (%25) sırt ve perine bölgelerinde yer yer bası yarası geliştiği gözlendi. Eksternal fiksatör uygulanan hastalarda cilt sorunlarıyla karşılaşılmadı. Konservatif tedavi gören hastalarda hastanede kaldıkları süre içinde ortalama beş kez (5-8 kez) radyografi çekilirken; eksternal fiksatörle tedavi edilenlerde ortalama iki kez (2-4 kez) radyografi çekildi. Konservatif tedavi gören hastalarda ortalama 0.6 cm (0.3-1.7 cm) uzunluk artışı gözlenirken eksternal fiksatörlü olgularda uzunluk artışı görülmedi.
Çıkarımlar: Kapalı femur kırıklı çocuklarda, eksternal fiksatörün özellikle yatak sıkıntısı ve personel yetersizliği olan kliniklerde iyi bir tedavi seçeneği olduğu sonucuna varıldı.

Article Details

Comparison of external fixation and pelvipedal cast treatments in closed femur diaphysis fractures in children

Authors:

Cumhur KESEMENLİ | Mehmet SUBASİ | Turgut KİRKGOZ | Serdar NECMİOGLU | Ahmet KAPUKAYA

Publisher:

Turkish Association of Orthopaedics and Traumatology

Journal:

Acta Orthopaedica et Traumatologica Turcica 2000 Vol.34 Issue 1, pp.40-44

Document Type:

Article

Publication Date:

9/2006

Document Language:

English

Document ID (Org No.):

2000813358

Frequency:

Bimonthly

eISSN:

1017-995X

pISSN:

1017-995X

casts

surgical;child;external fixators;femoral fractures/therapy/surgery;fractures/surgery;closed/surgery;traction

Issues

Article Details

Comparison of external fixation and pelvipedal cast treatments in closed femur diaphysis fractures in children

Authors: Cumhur KESEMENLİ | Mehmet SUBASİ | Turgut KİRKGOZ | Serdar NECMİOGLU | Ahmet KAPUKAYA

Publisher: Turkish Association of Orthopaedics and Traumatology

Journal: Acta Orthopaedica et Traumatologica Turcica 2000 Vol.34 Issue 1, pp.40-44

Document Type: Article

Publication Date: 9/2006

Document Language: English

Document ID (Org No.): 2000813358

Frequency: Bimonthly

eISSN: 1017-995X

pISSN: 1017-995X

casts

surgical;child;external fixators;femoral fractures/therapy/surgery;fractures/surgery;closed/surgery;traction

Issues

Authors:

Cumhur KESEMENLİ | Mehmet SUBASİ | Turgut KİRKGOZ | Serdar NECMİOGLU | Ahmet KAPUKAYA

Publisher:

Turkish Association of Orthopaedics and Traumatology

Journal:

Acta Orthopaedica et Traumatologica Turcica 2000 Vol.34 Issue 1, pp.40-44

Document Type:

Article

Publication Date:

9/2006

Document Language:

English

Document ID (Org No.):

2000813358

Frequency:

Bimonthly

eISSN:

1017-995X

pISSN:

1017-995X