The Clinical Study of the Proximal Shaft Fracture of the Femur in Children

Choi, Kyung Soo; Kim, Bong Chun; Chee, Seong Ku

Abstract

In general, satisfactory results can be obtained by nonoperative means in the management of proximal femoral shaft fracture in children. Howerver, it is sometimes difficult to maintain the fracture alignment by the nonoperative means because of different muscle pulls in the thigh. The proximal fragment tend to be displaced and roentgenograms are difficult to be taken during traction. These problems have led some authors to advocate open reduction and internal fixation which facilitate overall care. We report our experiences on nonoperative and.operative treatment for proximal femoral fracture at the Chon-ju Presbyterian Medical Center from February 1987 to January 1991. The results are as follows ; 1. There were 20 cases in male, 7 cases in female. Average age at injury was 6.9 years (range, 6 months to 12 years and 8 months). Traffic accident was the most common cause (70.3%). 2. Average immobillization time was 9.2 weeks (range, 6.0 weeks to 12.1 weeks) in the nonoperative treatment group(17 cases), while 8.1 weeks(range, 6.1 weeks to 11.4 weeks) in the operative treatment group (10 cases). 3. Average bony union time was 9.6 weeks (range, 6.3 weeks to 12.5 weeks) in the nonoperative treatment group(17. cases) and 11.2 weeks (range, 9.0 weeks to 13.4 weeks) in the operative treatment group (P < 0.05). 4. Average overgrowth of femur was 3.3mm(range, -5mm to 9mm) in the nonoperative treatment group (17 cases) and 5.4mm (range, Omm to 12mm) in the operative treatment group (10 cases). Howerver, there was no stataticlly significant differences in the overgrowth between the two groups. 5. Overall satisfactory results was similar between the nonoperative and the operative treatment group.