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The outcomes of pediatric femoral shaft fractures treated surgically by different types of orthopedists
Institution:1. Department of Orthopaedic Surgery, Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical College, Wenzhou, Zhejiang, China;2. Department of Orthopaedic Surgery, Wenzhou People’s Hospital, Wenzhou, Zhejiang, China;1. Department of Physiology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran;2. Department of Clinical Biochemistry, School of Medicine, Tarbiat Modares University, Tehran, Iran;3. Protein Chemistry Lab, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran;1. Department of Orthopaedics, Academic Medical Centre, 1105 AZ, Amsterdam, The Netherlands;2. Department of Orthopaedics, Amphia Hospital, Breda, 4819 EV, The Netherlands;1. Department of Orthopedic, Beijing Army General Hospital, Beijing, 100700, China;2. Department of Physical Medicine and Rehabilitation, Division of Pain Medicine, Mayo Clinic, Rochester, MN, 55901, USA;1. Joint Base Elmandorf, JBER, AK, 99506 USA;2. San Antonio Military Medical Center, Fort Sam Houston, TX, 78234, USA;3. The Hand Center, San Antonio, TX, 78240, USA
Abstract:BackgroundThe objective of this study was to compare the outcomes of pediatric femoral shaft fractures treated with titanium elastic nail (TEN) by pediatric orthopedists and non-pediatric orthopedists.MethodsFrom May 2006 to June 2014, 88 children with femoral shaft fractures were randomized to operative stabilization either by pediatric orthopedists (Group A, 44 cases) or by non-pediatric orthopedists (Group B, 44 cases). Demographic data and clinical characteristics (age, sex, weight, fracture side and type, cause of injury, associated injuries and interval from injury to surgery) were comparable between the two groups before surgery. Peri-operative data, clinical and functional outcomes between the two groups were recorded.ResultsThe mean follow-up period was 20.9 ± 4.5 months for Group A and 20.0 ± 3.6 months for Group B (P = 0.356). There was no significant difference in the time to union, length of hospitalization, full weight-bearing time and TEN scores between the two groups (P = 0.785, P = 0.835, P = 0.803, P = 0.940, respectively). However, the mean operating time and radiation time was longer in Group B than in Group A (P = 0.001 and P = 0.047, respectively). Also, there was a trend for patients of Group B to have a higher rate of open reduction (P = 0.047). When comparing the total complications, no significant difference existed between the groups (P = 0.978).ConclusionsThis study indicated that both pediatric and non-pediatric orthopedists provided satisfactory clinical and functional results in treating these common injuries.
Keywords:Children  Femoral shaft fractures  Surgical management  Titanium elastic nail  Functional outcome
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