MANAGEMENT OF CLOSED DIAPHYSEAL FRACTURE FEMUR IN OLDER CHILDREN USING THE ORTHOFIX DYNAMIC AXIAL FIXATOR

Abstract

The aim of this study was to evaluate the results of management of diaphyseal fractures of the femur in older children between the age of 6 - 16 years using Orthofix dynamic axial external fixatoafter foilow up of at least six months from the time of removal of the fixator.

Twenty patients were treated in this series and all of them attended the final follow up. The age of the patients ranged from six to sixteen years with a mean of 11.2 years. There were 18 males and two females. The right side was affected in 12 (60%) cases and the left in 8 (40%) cases. Ten fractures (50%) were transverse fractures; 6 comminuted (30%); two short oblique (10%) and 2 (10%) were spiral. The level of fractures was in the middle third in 10 cases (50%), proximal third in 6 cases(30) and in the distal third in 4 cases (20%).

Associated injuries other than femoral shaft fracture were present in 6 patients (30%). The minimum time lag before surgery was 5 days and maximum was 15 days with mean of 9.55 days. Ten cases (50%) were operated 5 - < 10 days following the injury while the other 50% were operated 10 - 15 days after the injury. The commonest cause of injury was road traffic accidents (15 patients or 75% of the cases), three cases (15%) were due to fall from height and in the remaining two cases, the actual cause of injury could be identified.