Epidemiology, clinical profile and therapeutic patterns of Paediatrics femoral fractures in Yaoundé: a cohort study.

CaHReF 2016, Yaoundé Conges hall, 23 – 26 August 2016 , PL018

We conducted a prospective cohort study of all consenting consecutive cases of femoral fractures in patients younger than 15 years managed between 2011 and 2015 at the surgical unit of Yaoundé University Teaching Hospital, Cameroon. We analysed demographic data, mechanisms of injury, fracture types, treatment options, therapeutic difficulties and outcome at 6 months of follow-up.

We studied 26 femoral fractures from 25 patients; 17 boys and 8 girls (mean age 4.4 years, range 4 days –13 years). All had closed fractures. The most common fracture location and line was the middle diaphysis (20) and spiral (10), respectively. Mechanisms of injury were; accidental falls (11), injuries during games (07), road traffic accidents (06) and obstetrical injury (01). Three patients presented with associated injuries to the head, ankle and soft tissues. Treatment modalities were tractions followed by casting (11), casting alone (08), closed reduction and casting (04), internal fixation by plates and screws (02) and external fixation (01). Major therapeutic difficulties were lack of appropriate anaesthesia techniques for closed reduction procedures, unsatisfied parents by prolonged periods of immobilization of their kids and lack of an intraoperative fluoroscopy to control alignment. The mean duration of consolidation was 2.3 months (range 1.2 – 3.4months). Apart from an acceptable limb length discrepancy after an osteosynthesis, no other complication was observed.

Femoral fractures often occur in children younger than 6 years who are males, in Yaoundé. Parents and children need to be sensitized on its preventable aetiologies so as to be more vigilant. The treatment of these fractures is predominated by conservative methods with good outcomes. However, current evidence-based surgical options like Elastic Stable Intramedullary Nailing are necessary for early patient rehabilitation and a better patient-parent satisfaction.

femoral fractures, children, treatment, difficulties, outcome, Yaounde