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Delayed Onset Iatrogenic Femur fracture in a Child Primarily treated with Cerclage Wires: Unrecorded Complications of an Unconventional Treatment Method

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Journal of Clinical Orthopaedics | Vol 8 | Issue 2 |  Jul-Dec 2023 | page: 91-93 | Amol Gharote, N S Laud, Bhavika Mehta, Ashok Shyam

DOI: https://doi.org/10.13107/jcorth.2023.v08i02.616

Authors: Amol Gharote [1], N S Laud [2], Bhavika Mehta [3], Ashok Shyam [3]

[1] Gharote Clinic, Thane Maharashtra, India.
[2] Laud Clinic, Dadar, Mumbai, Maharashtra, India.
[3] Sancheti Institute for Orthopaedics & Rehabilitation, Pune, Maharashtra, India.

Address of Correspondence
Dr. Bhavika Mehta
Sancheti Institute for Orthopaedics & Rehabilitation, Pune, Maharashtra, India..
E-mail: mehtabolismforyou@gmail.com

Abstract

Paediatric femur shaft fractures are common bony injuries in children. Although there are set protocol for these fractures, sometimes a deviation from standard methods may lead to unpredicted consequences. We report a case of femoral shaft fracture in a 8 years old boy which was primarily treated with 3 cerclage wires. The fracture healed over next few months but the child presented with refracture at the same site 11 months post first surgery. There was vascular compromise at the cerclage site which caused the fracture. This was treated with plate fixation and fracture finally healed. In this case report we highlight how not following the basic principles of treatment and management can lead to further complications. We also bring to light a previously unreported complication of one such unfavoured and rather unconventional method of fixation.
Keywords: Pediatric Femur Fracture, Cerclage, Nonunion, iatrogenic

References

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  8. M. van Steijn and J. Verhaar, “Osteonecrosis caused by percutaneous cerclage wiring of a tibial fracture: Case report,” Journal of Trauma, Injury, Infection, and Critical Care, vol. Volume 43 , no. 3 , pp. 521- 522 , 1997.
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How to Cite this article: Gharote A, Laud NS, Mehta B, Shyam A. Delayed Onset Iatrogenic Femur fracture in a Child Primarily treated with Cerclage Wires: Unrecorded Complications of an Unconventional Treatment Method. Journal of Clinical Orthopaedics 2023;8(2):91-93.

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Applying a Hip Spica in a Child

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Journal of Clinical Orthopaedics | Vol 7 | Issue 2 |  Jul-Dec 2022 | page: 27-29 | Darshan Kapoor, Sandeep V Vaidya

DOI: 10.13107/jcorth.2022.v07i02.521

Author: Darshan Kapoor [1], Sandeep V Vaidya [1,2]

[1] Department of Orthopaedics, Bai Jerbai Wadia Hospital for Children, Mumbai, Maharashtra, India,
[2] Department of Orthopaedics, Pinnacle Orthocentre Hospital, Thane, Maharashtra, India.

Address of Correspondence
Dr. Sandeep V Vaidya,
Department of Orthopaedics, Bai Jerbai Wadia Hospital for Children, Mumbai, Maharashtra, India.
E-mail: drsvvaidya@gmail.com

Abstract

Hip spica cast is a useful modality for the lower limb immobilization in children with hip and femur pathologies. Single, one and half, double limb spica cast may be applied depending on the indication. The position of hip immobilization is also dependent on the underlying pathology for which the spica is being applied. The inguinal region and knee are potential weak spots in a spica and these should reinforce during spica application. Potential complications include plaster sores, breakage, avascular necrosis of femoral head (in developmental dysplasia of hip), neurovascular compromise, and superior mesenteric artery syndrome (very rare). Careful attention to technique and vigilant after-care is necessary to prevent these complications.

Keywords: Hip spica cast, Pediatric femur fracture, Closed reduction, DDH

References

  1. Kumar SJ. Hip spica application for the treatment of congenital dislocation of the hip. J Pediatr Orthop 1981;1:97-9.
  2. Wan KL, Shanmugam R, Lee KY, Saw A. Comparing the mechanical strength of hip spica cast between a conventional and a new method of application. J Child Orthop 2016;10:387-94.
  3. Tisherman RT, Hoellwarth JS, Mendelson SA. Systematic. review of spica casting for the treatment of paediatric
    diaphyseal femur fractures. J Child Orthop 2018;12:136-44.
  4. Sargent MC. Single-leg spica cast application for treatment of pediatric femoral fracture. JBJS Essent Surg Tech
    2017;7:e26.

 

How to Cite this article: Kapoor D, Vaidya SV. Applying a Hip Spica in a Child. Journal of Clinical Orthopaedics Jul-Dec 2022;7(2):27-29.

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