If this is not your name, click here.
| | If this is not your name, click here. | | |
| | Contact Us | Order Now | Journals | Bookstore | Register a colleague | | |
| |  Pavlik Harness Can Be Used Safely for Infants Instead of Spica Cast After Treatment of Femoral Shaft Fractures: Presented at AAP By Nora Steiner Mealy SAN FRANCISCO, CA -- October 30, 2007 -- The Pavlik harness can be used safely in infants to treat femoral shaft fractures and does not lead to significant leg-length inequality, gait change, rotational change, or quadriceps atrophy, according to findings presented here at the American Academy of Pediatrics (AAP) 2007 National Conference and Exhibition. While an overgrowth response is expected following femoral shaft fracture in children older than 2 years, such a response is believed to be more variable in infants. Traditional treatment following a femoral shaft fracture in infants is traction to prevent shortening followed by a spica cast. To determine whether the use of a more flexible Pavlik harness and no traction would result in an unacceptable amount of shortening in the healing leg, researchers conducted a chart and radiograph review of 30 consecutive patients younger than 1 year old. Seven patients were excluded because they were lost to follow-up or had less than 18 months of follow-up. The remaining 15 boys and 8 girls studied had an average age of 5 months (range 1 day-11 months) at the time of injury and spent an average of 26 days (range 14-44 days) in the Pavlik harness. The treated limb was assessed at least 18 months following the injury using a teleoroentgenogram -- one film with a single exposure for the entire lower limb to measure limb lengths. In addition, patients were examined for range of motion, rotation, gait, and thigh circumference. The average radiographic shortening at injury was 7 mm (range 1-18 mm). Ten fractures were transverse and 13 were oblique. The average final radiographic femoral length was 2 mm longer on the injured leg (range 5 mm short, 5 mm long). Fourteen of 23 fractures had overgrowth averaging 5 mm (range 1-18 mm). Range of knee and hip motion was equal, and gait was symmetrical in all patients. Minor changes in hip rotation were seen in two patients, and thigh circumference differences of less than 5 mm were noted in three patients. The spica cast makes it more difficult for mothers to change their baby's diapers, to bathe and nurse their baby, and to bond with their baby, according to principal investigator William Hennrikus, MD, Department of Orthopaedics, Valley Childrens Hospital, Madera, California, United States. "The Pavlik harness is simple, safe, inexpensive, and well accepted by families for fractures of the femur in infants," he said. "It has replaced the spica cast as the treatment of choice today for this injury."
[Presentation title: Overgrowth After Femoral Shaft Fractures in Infants Treated With a Pavlik Harness. Abstract Number 412]
|
