Amer Aziz, Tauseef Haider.
Treatment of Closed Femoral Diaphseal fractures in children by Pins & Plastic technique (A prospective study).
Pak Postgrad Med J Jan ;12(1):12-4.

Femoral diaphyseal fracture is a common pediatric injury. The best method of treatment of these fractures is still controversial especially in age group 3-10 years. Forty children of age group 3-10 years having femoral diaphyseal fractures were treated by pins and plaster technique, a form of external fixation. No peroperative complications were recorded. Duration of anesthesia was only thirty minutes. Average duration of hospital stay was three days. Average operative expenditure was approximately Rs.500, excluding the cost of anesthetic drugs. Three months follow-up was done. Satisfactory fracture alignment and union (7-9 weeks duration) was achieved in 36 cases (90%). All these patients started full weight bearing at 10-12 weeks post-operative period. There were three cases (7.5"/0) of severe pin tract infection leading to loss of fixation and one case (2.5%) had loss of fixation primarily at two weeks postoperative period. Limb shortening of upto 1.5 cm was recorded in six cases (15%). Pin tract infection was the major problem. Overall pin tract infection rate was 57.5%. Out of these, 7.5% (3 cases) had severe pin tract infection leading to the loss of fixation. In all other cases, infection was superficial and was controlled with antibiotics after the removal of fixation. The study. concluded that the pin and plaster fixation is a simpler, cheaper and minimally invasive form of fixation of pediatric femoral fractures but with a high rate of pin tract infection which is difficult to control because of non availability of pin entry sites in the plaster for pin tract care.

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