Traitement Chirurgical Des Fractures Du Fémur De L’enfant

Abstract

Objective To describe indications, different modalities and results of surgical treatment of femur fractures in children. Patients and methods This is a retrospective study from January 2004 to December 2013 in the pediatric surgery department of Lomé Sylvanius Olympio teaching hospital, from the records of patients aged 0-15 years with femur fractured treated surgically. Results There were 66.1% (39 cases) of shaft fractures of which 53.57% localized in the middle third. Of the 33.9% (20 cases) of the lower extremity fracture, epiphyseal growth fractures accounted for 13 cases including seven (7) for type II among Salter-Harris classification. The indications were: femoral fracture occurred in the context of multiple trauma (4 cases), patients over 11 years (40 cases), failure of conservative treatment (2 patients), epiphyseal growth fractures of the distal femur after failure of conservative treatment (12 patients) and an epiphyseal growth fracture type 4 of Salter and Harris where surgery was indicated immediately (1 case). The average time of surgical treatment was 32 days. The elastic stable intramedullary nailing (ESIN) was made in 66.1% of patients, the plate in 18.6%, the pinning in 11.9% and screwing in 3.4%. The average duration of hospital stay was 45.16 days. Removal of osteosynthesis material was performed in 38 patients or 64.4% of cases. The average time of this removal was 8 months.Conclusion The methods of the most widely used surgical treatment are open ESIN because of the long waiting patients associated with very limited financial resources. This method has real advantages and should be encouraged in our communities by improving the technical facilities and living conditions of the population.