Comparative Study Between Single-limb Versus One-and-a-Half Hip Spica Cast in Fracture Femur in Young Children.

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Mohamed S Hamdy, Ahmed O Sabry, Bishoy A Helmy, Atef Z Hana, Aly M E El Zawahry, Andrew Gamal
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引用次数: 0

Abstract

Introduction: Femoral fractures account for ∼1% to 2% of all pediatric bone injuries and are a common occurrence in children. The conservative approach, employing either a single or one-and-a-half spica casts, has been traditionally favored, yielding satisfactory outcomes in select cases. This study aims to compare both procedures regarding functional and radiologic outcomes, complications, and parents' satisfaction.

Methods: In this randomized controlled trial, we enrolled 84 pediatric patients, aged between 2 and 6 years, presenting with femoral fractures. Participants were randomly allocated into 2 groups; one receiving single-limb spica cast fixation (n=42) and the other receiving one-and-a-half spica cast fixation (n=42). We assessed postprocedural functional and radiologic outcomes. Other evaluations focused on parental ease in maintaining hygiene for the casted child, the child's mobility capabilities including standing and crawling, and the incidence of skin complications.

Results: No significant variance was observed between the 2 groups concerning the time to bone union, and the overall complication rates. Parental satisfaction was notably higher in the single-limb spica group, particularly regarding the ease of maintaining hygiene for the casted child and the child's mobility while encased in the cast (P<0.001). Furthermore, a significant correlation was identified between the one-and-a-half spica application and the increased occurrence of skin pressure ulcers (P<0.001).

Conclusion: Both single-limb and one-and-a-half spica cast applications demonstrated comparable results in functional and radiologic outcomes, as well as in complication rates. However, parents favored the single-limb method due to its facilitation of a more manageable lifestyle for both the child and their parents. These considerations suggest that the single-limb hip spica cast fixation may be preferable in managing pediatric femoral fractures.

Level of evidence: Level II.

幼儿股骨骨折中单肢与单半髋Spica石膏的比较研究
导言:股骨骨折占小儿骨伤总数的 1%至 2%,是小儿常见的骨折。采用单个或一个半斯派卡石膏固定的保守方法历来受到青睐,在特定病例中取得了令人满意的结果。本研究旨在比较两种方法在功能和放射学效果、并发症以及家长满意度方面的差异:在这项随机对照试验中,我们招募了 84 名股骨骨折的儿童患者,年龄在 2 到 6 岁之间。参与者被随机分为两组:一组接受单肢斯派卡石膏固定(42人),另一组接受单肢半斯派卡石膏固定(42人)。我们对术后功能和放射学结果进行了评估。其他评估的重点是家长为石膏患儿保持卫生的难易程度、患儿的活动能力(包括站立和爬行)以及皮肤并发症的发生率:结果:在骨结合时间和总体并发症发生率方面,两组之间没有发现明显差异。单肢斯派卡组的家长满意度明显更高,尤其是在保持石膏患儿的卫生和石膏包裹下患儿的活动能力方面:在功能和放射学结果以及并发症发生率方面,单肢和一肢半石膏的应用效果相当。不过,家长们更倾向于单肢方法,因为这种方法能让患儿和家长过上更轻松的生活。这些因素表明,在处理小儿股骨骨折时,单肢髋关节斯派卡石膏固定可能更为可取:证据等级:二级。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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