RESEARCH ARTICLE


A Prospective Cohort Study of the Therapeutic Patterns, Challenges and Outcomes of Paediatric Femoral Fractures in a Cameroonian Tertiary Center



Joel Noutakdie Tochie1, 2, *, Marc Leroy Guifo1, 2, Marie-Ange Ngo Yamben1, 3, Roger Moulion4, Ibrahim Farikou1, 3
1 Department of Surgery and Sub-specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
2 Department of Surgery, University Teaching Hospital of Yaoundé, Yaoundé, Cameroon
3 Department of Orthopaedics and Traumatology, Yaoundé Rehabilitation Centre, Yaoundé, Cameroon
4 Department of Radiology and Medical Imaging, University Teaching Hospital of Yaoundé, Yaoundé, Cameroon


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© 2017 Tochie et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the University Teaching Hospital of Yaoundé, Yaoundé, P.O. Box 2666, Cameroon; Tel: +237 676558825; E-mail: joeltochie@gmail.com


Abstract

Background:

Knowledge of the therapeutic patterns, challenges and outcomes of treatment of paediatric femoral fractures (PFF) helps to better choose the ideal therapeutic modality which is still controversial. However, this data is scarce in the sub-Saharan African literature.

Objective:

To determine the therapeutic patterns, treatment challenges and outcomes of treatment of PFF in a tertiary care centre in Cameroon.

Method:

We conducted a prospective cohort study of all consenting consecutive cases of femoral fractures in patients younger than 16 years managed between 2011 and 2015 at the surgical unit of Yaoundé University Teaching Hospital, Cameroon. We analysed demographic data, injury characteristics, fracture patterns, treatment details, therapeutic challenges and outcomes of treatment at 12 months using Flynn’s criteria.

Results:

We enrolled 30 femoral fractures from 29 children with mean age was 4.2 ± 3.3 years. The male gender, diaphyseal locations and spiral fracture lines were predominant. Main mechanisms of injury were accidental falls, road traffic accidents and game injuries. Fracture management entailed 12 tractions followed by casting, 10 casting alone, four closed reductions followed by casting, two cannulated screw fixations, one pin fixation and one external fixation. The mean duration of consolidation was 10.3 ± 3.9 weeks. The outcome was rated excellent in 28 cases. Limited resources precluded fluoroscopy use, proper anaesthetic management, early rehabilitation and patient-parent satisfaction.

Conclusion:

Conservative management of PFF yields a good outcome in our setting. However, an improvement in surgical, radiology and anaesthetic infrastructure is needed for optimal PFF care.

Keywords: Femoral fractures, Paediatric, Treatment, Challenges, Outcomes, Cameroon.