Pediatric diaphyseal femoral fractures at Tribhuvan University Teaching Hospital, Nepal - No major differences between conservative and surgical treatments

摘要

AbstractBACKGROUND: Fractures have a big impact on children's lives and daily activities. Thediaphyseal femoral fractures account for around 2 percent of all pediatric fractures. Treatmentincludes conservative (non-surgical) or surgical methods but the choice of treatment differsdepending on the child's age, fracture pattern, other concomitant fractures and the socioeconomicsituation of the family. These methods have different advantages and disadvantagesand there is no consensus of which method is most ideal.AIM: The aim of this study was to map the cause of fracture, treatments and outcomes ofpediatric diaphyseal femoral fractures at TUTH, Nepal. There are few studies on pediatricfemoral fractures in Nepal, which means that a further survey will contribute to existingresearch in this area.METHODS: This was a retrospective observational study with a prospective phone followup.The patients included in this study were diagnosed with diaphyseal femur fracture andwere 0-18 years old. Out of 106 patients selected, only 55 were included in the study and 24participated in the outcome follow-up.RESULTS AND CONCLUSIONS: Out of 55 patients 25 were males and 30 females.Conservative treatment was the most common treatment. The mean age of incurring this typeof fracture was 6.31 years. The dominating cause of injury among all children was fall fromabove standing height. A conservative treatment was given mainly to younger children, whilea surgical treatment was given to older children and those sustaining poly-trauma.Conservative treatment was cheaper compared to surgical treatment. Regardless of the choiceof treatment, the outcome after fracture appears to be satisfactory. It is recommended thatfuture studies have a large patient sample and address the clinical outcomes, but also thesocial and economic aspects.