TY - JOUR
T1 - Early versus delayed stabilization of pediatric femur fractures
T2 - Analysis of 387 patients
AU - Hedequist, Daniel
AU - Starr, Adam J.
AU - Wilson, Philip
AU - Walker, Joan
PY - 1999/9/1
Y1 - 1999/9/1
N2 - Objectives: To assess the effect of timing of femur fracture stabilization on pulmonary complication rates in pediatric trauma patients. Design: Retrospective review. Setting: Level I trauma center. Patients: Three hundred eighty-seven previously healthy patients from zero to fifteen years of age with traumatic diaphyseal femur fractures. Intervention: Femur fracture stabilization: early (less than twenty-four hours after injury) in 213 patients and late in 174 patients. Main Outcome Measurements: Age, sex, GCS (Glasgow Coma Score), AIS/ISS (Abbreviated Injury Score/Injury Severity Score), timing of fracture stabilization, duration of mechanical ventilation, intensive care unit stay, and hospital stay were recorded. Pulmonary complications, including pneumonia, respiratory distress syndrome, and pulmonary embolus, were recorded. Results: Thirteen patients developed pulmonary complications. Twelve of these had severe head injuries (GCS ≤ 8). One had sustained an upper cervical spine fracture that resulted in quadriplegia. Statistical analysis revealed GCS, GCS ≤ 8, ISS, and head and neck AIS to be significant predictors of pulmonary complications. Early stabilization of femur fractures had no apparent effect on the pulmonary complication rate. Conclusions: Pulmonary complications are rare in pediatric femur fracture patients. Patients with severe head injuries (GCS ≤ 8) or cervical spinal cord injuries are at high risk for pulmonary complications. The timing of femur fracture stabilization does not appear to affect the prevalence of pulmonary complications in these patients.
AB - Objectives: To assess the effect of timing of femur fracture stabilization on pulmonary complication rates in pediatric trauma patients. Design: Retrospective review. Setting: Level I trauma center. Patients: Three hundred eighty-seven previously healthy patients from zero to fifteen years of age with traumatic diaphyseal femur fractures. Intervention: Femur fracture stabilization: early (less than twenty-four hours after injury) in 213 patients and late in 174 patients. Main Outcome Measurements: Age, sex, GCS (Glasgow Coma Score), AIS/ISS (Abbreviated Injury Score/Injury Severity Score), timing of fracture stabilization, duration of mechanical ventilation, intensive care unit stay, and hospital stay were recorded. Pulmonary complications, including pneumonia, respiratory distress syndrome, and pulmonary embolus, were recorded. Results: Thirteen patients developed pulmonary complications. Twelve of these had severe head injuries (GCS ≤ 8). One had sustained an upper cervical spine fracture that resulted in quadriplegia. Statistical analysis revealed GCS, GCS ≤ 8, ISS, and head and neck AIS to be significant predictors of pulmonary complications. Early stabilization of femur fractures had no apparent effect on the pulmonary complication rate. Conclusions: Pulmonary complications are rare in pediatric femur fracture patients. Patients with severe head injuries (GCS ≤ 8) or cervical spinal cord injuries are at high risk for pulmonary complications. The timing of femur fracture stabilization does not appear to affect the prevalence of pulmonary complications in these patients.
KW - Delayed stabilization
KW - Early stabilization
KW - Fracture
KW - Pediatric trauma
KW - Pulmonary complications
UR - http://www.scopus.com/inward/record.url?scp=0033194470&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0033194470&partnerID=8YFLogxK
U2 - 10.1097/00005131-199909000-00005
DO - 10.1097/00005131-199909000-00005
M3 - Article
C2 - 10513971
AN - SCOPUS:0033194470
SN - 0890-5339
VL - 13
SP - 490
EP - 493
JO - Journal of orthopaedic trauma
JF - Journal of orthopaedic trauma
IS - 7
ER -