Femoral Shaft Fractures: Management and Outcome in Nigerian Children.

Abstract

Traditionally, majority of femoral shaft fractures in children are managed by conservative methods with good results. Recently, there is a trend towards
operative treatment. This study aims to determine the indications and outcome of dynamic compression plating in children and adolescents.
This was a-10-year prospective study of open reduction and internal fixation carried out in
three hospitals in North Central Nigeria. Data analysed included personal demographic data, aetiology, hospital of primary treatment, indications for surgery, methods chosen,
duration of hospitalization and time to mobilization. Follow upwas till removal of implants.
Thirty-one patients were treated by dynamic compression plating during this period.Therewere 20males (64.5%) and 11 females (35.5%), with a mean age of 12.1(±3.3) years. Twenty-one (67.7%) fractures resulted from road traffic accidents, 9 (29.0%) from falls and one (3.3%)was spontaneous pathological fracture. Twenty patients (64.5%) presented first to the traditional bone setters while 11(35.5%) to orthodox
hospitals.The indications for interventionweremainly due to malunion of fractures in 20 (64.5%) and surgeons\'/parents\' preference in six (19.4%) patients. The mean duration of hospitalization was 4 (SD±1.7) weeks. Fracture union was achieved in 8-13 weeks (mean =
10 ±1.7) weeks. Infection rate was 3.2% and mal-union occurred in one (3.2%) patient who had osteogenesis imperfecta. Compression plating is a suitable option in
treatment of childhood and adolescent femoral fractures.

Keywords: Femoral shaft fracture, Compression plating, traditional bone setters, children and adolescents.

African Journal of Paediatric Surgery Vol. 4 (1) 2007: pp. 33-36