La fijación externa monolateral en el tratamiento de las fracturas femorales del niño: experiencia preliminar en 20 casos

Twenty children with simple femoral-shaft fractures were treated by monolateral external fixation with the Wagner device. There were 11 boys and 9 girls with a mean age of 8 years (3-15). Twelve fractures were located at the midshaft, 6 at the proximal third, and 2 other at the distal third of the femur. The mean hospital stay was 9 days (5-20). Mean external fixation time was 61 years. In 5 cases, additional methods of treatment were required. Pin tract infection occurred in 3 cases (one needed premature removal of the device). Except for one case, full range of knee motion was usually achieved after treatment. In patients followed for more than 18 months, a mean femoral overgrowth of 0.8 cm (0.5-1.5) was detected. Neither angular deformities nor malrotations were observed. In our experience, the main advantages of external fixation for femoral-shaft fractures in children include less hospitalization time and an easier and more confortable nursing. External fixation allows a better control of the bone fragments, providing an adequate stability. Pin tract infection seems to be the most important drawback. A learning curve was observed in this series.