Epidemiology Of Femur Fractures Research Articles

Epidemiology of Femur Fractures in Children: A Descriptive Cross Sectional Study Based on a Rural Population of Nepal.

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.

Complications in the surgical management of femur fractures in children with non-ambulatory cerebral palsy

Children with severe non-ambulatory cerebral palsy (CP) are at high risk of sustaining a pathological femur fracture.1,2 These fractures are rare. In a review of the epidemiology of femur fractures in children from Cape Town, the prevalence of femoral pathological fractures related to cerebral palsy was less than three per cent.3 These patients often have multiple co-morbidities which predispose them to pathological femur fractures.3-6 The gold standard of treatment for these fractures is conservative management with either traction or cast immobilisation. The incidence of complications has been reported as extremely high in a number of studies after surgical management of these fractures.1,7 The objectives of this case report are to discuss the aetiology of these fractures, emphasise the role of conservative management as the gold standard of treatment, and highlight complications of surgical treatment in children with non-ambulatory cerebral palsy.