Ischial Weight Bearing Brace after Skin Traction for Treatment of Femoral Shaft Fractures in Children

Kim, Dong Heon; Oh, Jae Jin; Yang, Joonho

Abstract

PURPOSE: Most of the pediatric femoral shaft fractures are treated conservatively such as traction therapy followed by cast fixation. At Konkuk University Hospital, for those pediatric femoral shaft fractures that managed well with skin traction without having to perform bone traction, we utilized skin traction until callus appear on the radiologic studies. At this time, they wore ischial weight bearing braces were and forced on early ambulation with satisfactory result. MATERIAL AND METHODS: The pediatric patients between 2 to 10 years of age with femoral shaft fractures during January 1993 to January 1997 were selected for the study. They were treated with skin traction followed by wearing ischial weight-bearing braces. From the 39 selected cases, we selected 32 cases with 1-year follow-ups. For each case, results from before and after the treatment were studied
RESULTS
The average post-therapy angular changes were that the varus angle change was 10.2, anterior 10.6. There were 7 cases of malunion, 6 cases of anterior angle change, 1 case of varus angle change. The average duration of skin traction was 4.3 weeks and initiation of weight-bearing was 5.8 weeks. We observed 6 cases of limblength discrepancy, but no signs of claudication in any cases.
CONCLUSION
In pediatric femoral shaft fractures, if the alignment is maintained well, then we can utilize skin traction followed by ischial weight-bearing braces, which enables earlier ambulation than the cast fixation. Also skin traction and weight-bearing braces has less complication than the cast fixation.