MANAGEMENT OF PAEDIATRIC FEMORAL SHAFT FRACTURE BY THIGH BRACE FOLLOWING TRACTION IN THE AGE GROUP OF 1-6 YEARS

Md. Yakub Ali*, Mohammad Suman Sutar, Obaidur Rahman and Md. Ehteshamul Choudhury

ABSTRACT

Pediatric femoral shaft fractures are common occurrences and frequently require hospitalization for management and thereby add to the economic burden. Child’s age, height, weight and the fracture type dictates the treatment strategy and includes casting, skin traction, Pavlik harness etc. Currently, thigh brace following traction in treatment of shaft femur fracture in the age group of 1 to six years is gaining popularity. Therefore aim of this study was to evaluate the outcome when femur shaft fractures in the age group of 1-6 years were treated with traction followed by thigh brace. This prospective observational study was conducted in NITOR from July 2017 to June 2019 on 62 children, enrolled by inclusion and exclusion criteria, with fractured femoral shaft. Clinical, radiological and functional outcomes were assessed to derive conclusion at final follow-up. Mean age of the cases was 4.09±1.55 year with a male-female ratio of 5.2:1. Mean bridging callus formation time was 2.45±0.53 weeks. Thigh brace was applied after appearance of bridging callus. The mean duration of radiological union time was 6.6±1.47 weeks. At last follow up, the mean LLD was 0.15±0.37 cm and notable complications were pain (4.8%), skin irritation (4.84%) and muscle wasting (3.23%). The mean coronal, sagittal & rotational mal-alignment were 0.81±1.85 degree, 3.23±4.26 degree and 1.13±2.47 degree respectively. As per Flynn criteria at last follow up, 54 (87.1%) were scored excellent, 8.06% patients were found satisfactory and 4.84% had poor outcome. So it is concluded that the application of thigh brace is safe and effective method in treating pediatric femoral shaft fractures in age group of 1 to 6 years.

Keywords: Paediatric trauma, Fracture Shaft of Femur, Traction, Thigh Brace.