Dynamic skeletal traction spica casts for paediatric femoral fractures in a resource-limited setting

Dynamic skeletal traction spica casts for paediatric femoral fractures in a resource-limited setting

The objective of this study was to compare elastic intramedullary nailing (EIN) with dynamic skeletal traction spica casting (DSTSC) in terms of postoperative radiographic angulations, length of hospital stay, and cost in a resource-limited setting. We prospectively studied 51 children, five to twel...

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Bibliographic Details
Published in:International orthopaedics Vol. 33; no. 3; pp. 765 - 771
Main Authors: Hsu, Andrew R., Diaz, Hilario M., Penaranda, Noel Rex P., Cui, Heherson D., Evangelista, Rowena Helena A., Rinsky, Lawrence, Gracilla, Ranulfo V.
Format: Journal Article
Language:English
Published: Berlin/Heidelberg Springer-Verlag 01-06-2009
Subjects:
Age
Bone Nails
Casts, Surgical - economics
Child
Child, Preschool
Children
Female
Femoral Fractures - economics
Femoral Fractures - therapy
Femur
Fracture Fixation, Intramedullary - economics
Fracture Fixation, Intramedullary - instrumentation
Fracture Fixation, Intramedullary - methods
Fracture Healing
Fractures
Health Care Costs
Health Resources - economics
Hospitals
Humans
Length of Stay
Male
Medicine
Medicine & Public Health
Original Paper
Orthopedics
Pediatrics
Prospective Studies
Range of Motion, Articular
Surgery
Traction - instrumentation
Traction - methods
Kirschner Wire
Spica Casting
Current Market Price
Titanium Elastic Nail
Decrease Hospital Stay
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Summary:The objective of this study was to compare elastic intramedullary nailing (EIN) with dynamic skeletal traction spica casting (DSTSC) in terms of postoperative radiographic angulations, length of hospital stay, and cost in a resource-limited setting. We prospectively studied 51 children, five to twelve years of age, with femoral fractures treated with either EIN ( n  = 26) or DSTSC ( n  = 25). Children treated with EIN had significantly longer hospital stays (17 ± 8.0 days) than those treated with DSTSC (6.0 ± 2.5 days). Financial constraints in acquiring supplies caused a significant increase in time from admission to surgery (EIN 9.5 ± 2.3 days; DSTSC 1.1 ± 0.3 days), and cost was about 400% higher for EIN compared with DSTSC. At twelve weeks follow-up, all patients in both groups had acceptable radiographic angulations. In resource-limited healthcare settings, DSTSC is an effective alternative to EIN with comparable post-op radiographic angulations, decreased hospital stays, and lower cost.
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ISSN:0341-2695
1432-5195
DOI:10.1007/s00264-008-0621-0