Outcome of non-operative management of femoral shaft fractures in children

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 nonoperatively 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.