The outcomes of pediatric femoral shaft fractures treated surgically by different types of orthopedists

• Published in: Injury Vol. 48; no. 2; pp. 548 - 551
• Main Authors: Lu, Di, Yang, Jie, Zhang, Jing-Dong, Chen, Hua, Sun, Liao-Jun
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-02-2017
• Subjects: Bone Nails; Child; Children; China; Female; Femoral Fractures - diagnostic imaging; Femoral Fractures - physiopathology; Femoral Fractures - surgery; Femoral shaft fractures; Fracture Fixation, Intramedullary - instrumentation; Fracture Fixation, Intramedullary - methods; Fracture Healing; Functional outcome; Humans; Male; Operative Time; Orthopedic Surgeons; Orthopedics; Pediatrics; Postoperative Complications - diagnostic imaging; Postoperative Complications - surgery; Practice Patterns, Physicians' - statistics & numerical data; Prospective Studies; Radiography; Surgical management; Titanium elastic nail; Treatment Outcome; Surgical management; Titanium elastic nail; Children; Femoral shaft fractures; Functional outcome
• ISSN: 0020-1383; 1879-0267
• DOI: 10.1016/j.injury.2016.11.032

Abstract Background The objective of this study was to compare the outcomes of pediatric femoral shaft fractures treated with titanium elastic nail (TEN) by pediatric orthopedists and non-pediatric orthopedists. Methods From May 2006 to June 2014, 88 children with femoral shaft fractures were randomized to operative stabilization either by pediatric orthopedists (Group A, 44 cases) or by non-pediatric orthopedists (Group B, 44 cases). Demographic data and clinical characteristics (age, sex, weight, fracture side and type, cause of injury, associated injuries and interval from injury to surgery) were comparable between the two groups before surgery. Peri-operative data, clinical and functional outcomes between the two groups were recorded. Results The mean follow-up period was 20.9 ± 4.5 months for Group A and 20.0 ± 3.6 months for Group B ( P = 0.356). There was no significant difference in the time to union, length of hospitalization, full weight-bearing time and TEN scores between the two groups ( P = 0.785, P = 0.835, P = 0.803, P = 0.940, respectively). However, the mean operating time and radiation time was longer in Group B than in Group A ( P = 0.001 and P = 0.047, respectively). Also, there was a trend for patients of Group B to have a higher rate of open reduction ( P = 0.047). When comparing the total complications, no significant difference existed between the groups ( P = 0.978). Conclusions This study indicated that both pediatric and non-pediatric orthopedists provided satisfactory clinical and functional results in treating these common injuries.