[Bed rest and skin traction for Perthes' disease: review of the literature].

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Abstract

[Indexed for MEDLINE] 18. Children (Basel). 2020 Oct 1;7(10):156. doi: 10.3390/children7100156. Perinatal Femoral Fracture: A Ten-Year Observational Case Series Study. Pavone V(1), Vescio A(1), Montemagno M(1), de Cristo C(2), Lucenti L(3), Pavone P(4), Testa G(1). Author information: (1)Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico-Vittorio Emanuele, University of Catania, 95123 Catania, Italy. (2)Dipartimento Ortopedia e Traumatologia-Ospedale Santa Maria Goretti, 04100 Latina, Italy. (3)Dipartimento Ortopedia e Traumatologia-Policlinico Casilino, 00169 Roma, Italy. (4)Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University of Catania, 95123 Catania, Italy. BACKGROUND: perinatal femoral fractures (PFF) are relative rare birth-related fractures. Among treatment options, Bryant traction reported satisfactory outcomes in PFF of children under 3 years of age. The aim of this study is to assess the risk factors, diagnosis, management, and outcome in the 10-year multicentric experiences of all newborns treated for PFF in Catania city hospitals. METHODS: 15,628 children, hospitalized in four neonatal units, were retrospectively reviewed. The following data were collected: gender, birth weight, gestational age, presentation, mode delivery, and fracture type according to AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF). In each case, diagnosis was achieved after the clinical examination and X-Ray exam. Each patient underwent Bryant's skin traction of the affected limb, and was clinically followed for at least two years. RESULTS: eight newborns were included in the study (five males). The average birth weight was 2.656 kg with a gestational age of 37.5 weeks; 4 cases were preterm birth; 5 patients had a cephalic presentation. According to the AO PCCF classification, three fractures were ranked 32-D/4.1 and five were 32-D/5.1. The entire cohort had an excellent outcome. CONCLUSIONS: prematurity, low birth weight, and caesarean section could be PFF risk factors. Bryant's skin traction is an effective option to achieve an excellent outcome. DOI: 10.3390/children7100156 PMCID: PMC7601572