Abstract
Femur fracture in children is one of the most common lower limb fractures which require inpatient care. The aim of this study is to determine the epidemiology of femoral shaft fractures in children from a rural population of Karnali Nepal. Hospital records were retrospectively reviewed from May 2017 to April 2020 to identify all the children with femur fracture. Sociodemographic profile, mode of injury, fracture pattern and location, time of presentation, initial treatment by traditional bone setters, treatment method and duration of hospital stay were noted. Data analysis was done using Statistical Package for Social Sciences version 20. Altogether 104 children were identified. The mean age was 5.55 years and boys predominated 65 (62.5%). Falls were the major mode of injury in 65 (62.4%) patients. Fractures were frequently noted between April 15 to August 15. There were four (3.8%) open fractures and concurrent fracture observed in eight (7.6%) patients. Ten (9.6%) children received prior treatment from traditional bonesetters. Treatment methods included hip spica 62 (59.6%), elastic intramedullary nailing 30 (28.8%) and plate fixation 12 (11.5%). The duration of hospital stay in the nailing and plate fixation group was 11.43 days and 18 days respectively. Fracture was common in 2-6 years of age group in boys during summer. Fall from cliff, rooftop and ladder were the major preventable cause of fracture. Delayed presentation and prior treatment with traditional bone setters add special challenges to orthopedic surgeons working in rural teaching hospital.
Highlights
Femur fracture in children is one of the most common lower limb fractures which require inpatient care
Rokaya et al Epidemiology of Femur Fractures in Children: A Descriptive Cross-sectional Study Based on a Rural Population of Nepal osteosynthesis with dynamic compression plate and screws
Pattern and treatment methods of childhood femur fractures have been conducted in urban settings of developed countries.25To our understanding, epidemiological study on childhood femur fracture has not been conducted in rural population of Nepal till date
Summary
Femur fracture in children is one of the most common lower limb fractures which require inpatient care. The aim of this study is to determine the epidemiology of femoral shaft fractures in children from a rural population of Karnali Nepal. Femoral shaft fracture in children is one of the most common lower limb fractures requiring inpatient admission. They represent 1.6 % of all fractures in children.1At present, we treat children below six years with one and a half spica with or without prior traction. Rokaya et al Epidemiology of Femur Fractures in Children: A Descriptive Cross-sectional Study Based on a Rural Population of Nepal osteosynthesis with dynamic compression plate and screws. Karnali has literacy rate of 62.7% and the lowest human development index 0.445 as compared to other parts of Nepal.[7]
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