Pediatric diaphyseal femoral fractures at Tribhuvan University Teaching Hospital, Nepal - No major differences between conservative and surgical treatments

Abstract

Abstract BACKGROUND: Fractures have a big impact on children's lives and daily activities. The diaphyseal femoral fractures account for around 2 percent of all pediatric fractures. Treatment includes conservative (non-surgical) or surgical methods but the choice of treatment differs depending on the child's age, fracture pattern, other concomitant fractures and the socioeconomic situation of the family. These methods have different advantages and disadvantages and there is no consensus of which method is most ideal. AIM: The aim of this study was to map the cause of fracture, treatments and outcomes of pediatric diaphyseal femoral fractures at TUTH, Nepal. There are few studies on pediatric femoral fractures in Nepal, which means that a further survey will contribute to existing research in this area. METHODS: This was a retrospective observational study with a prospective phone followup. The patients included in this study were diagnosed with diaphyseal femur fracture and were 0-18 years old. Out of 106 patients selected, only 55 were included in the study and 24 participated in the outcome follow-up. RESULTS AND CONCLUSIONS: Out of 55 patients 25 were males and 30 females. Conservative treatment was the most common treatment. The mean age of incurring this type of fracture was 6.31 years. The dominating cause of injury among all children was fall from above standing height. A conservative treatment was given mainly to younger children, while a surgical treatment was given to older children and those sustaining poly-trauma. Conservative treatment was cheaper compared to surgical treatment. Regardless of the choice of treatment, the outcome after fracture appears to be satisfactory. It is recommended that future studies have a large patient sample and address the clinical outcomes, but also the social and economic aspects.