ABSTRACT
Background: Femoral shaft fractures are common injuries in childhood. There is paucity of information on their presentation and outcome of the available treatment methods in the African population. This study evaluated the outcome of non-operative methods of treatment of femoral shaft fractures in our centre. Patients and Methods: A retrospective review of the database of children aged 14 years and below with femoral shaft fractures treated non-operatively over a 10-year period. Results: A total of 134 patients with 138 fractures met the study criteria. This consisted of 71 boys (mean age = 6.1 years ± SD) and 63 girls (mean age = 6.5 years ± SD). Pedestrian vehicular accident was the most common cause of femoral shaft fractures in the study population. The midshaft was the most common site of fractures. There were associated injuries to other parts of the body (especially head injury) in 34.3% of the patients. The commonest mode of treatment was skin traction only (87.7%). The mean time to fracture union was 4.9 weeks ± SD (range = 3-15 weeks). The mean length of hospitalisation was 6.7 weeks ± SD (range = 5 days-11 weeks). There was a fairly strong positive correlation between the length of hospitalisation and the presence of associated injuries, especially head injury, upper limb fractures and bilaterality of the fractures. The mean total cost of treatment was #7685 (Naira) or $51.2 (range = $14.2-$190). At the last follow up, 97.8% of the fractures united without significant angulation or shortening. Conclusion: The outcome of non-operative treatment of femoral shaft fractures in our setting is comparable to the results of other workers. Methods of treatment that shorten the length of hospitalisation without unduly increasing cost should be encouraged
Subject(s)
Causality , Child , Femoral Fractures/therapy , Health Care Costs , Length of Stay , Nigeria , Treatment OutcomeABSTRACT
One hundred and three femoral shaft fractures treated by open intramedullary Kuntscher nailing between July 1998 and June 2001 were studied retrospectively. Their ages ranged between 9 and 70 years of age with a mean age 30.6 years; males accounting for 82.5. Most of the injuries (72.8) resulted from road traffic accidents. All were operated late after failure of traction with time between injury and surgery ranging from one week to 16 weeks; with a mean duration of 7 weeks. The commonest complication was reduced knee flexion; with 16 (16) of the patients having a knee flexion of less than 1000 six weeks after surgery. Osteomyelitis occurred in 3 patients (2.9) but all had full recovery after control of the infection. Fatigue fracture of nails (implant failure) requiring renailing occurred in 7 patients (6.8). These results support the continued use of open intramedullary Kuntscher nailing of femoral shaft fractures in developing countries where the necessary infrastructure and expertise required for closed interlocking intramedullary nailing is not available