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Topic:

Femoral Shaft Fracture

Issue:

Thigh

Category:

Trauma

Title:

Recovery of Gait in Children and Adolescents After Pediatric Femoral Shaft Fracture Treated With Intramedullary Nail Fixation: A Longitudinal Prospective Study

Author:

Flinck, Marianne MD; Riad, Jacques MD, PhD

Journal:

Journal of Pediatric Orthopaedics

Date:

January 2024

Reference:

44(1): p 1-6, DOI: 10.1097/BPO.0000000000002537

Level Of Evidence:

III

# of Patients:

17

Study Type:

Prospective cohort study

Location:

Not specified

Summary:

This study investigates the recovery of gait in children and adolescents after femoral shaft fractures treated with intramedullary nail fixation, using both clinical assessments and three-dimensional gait analysis.

Methods:

Inclusion: Children aged 6 to 16 years with femoral shaft fractures treated with intramedullary nails. Exclusion: Pathologic fractures or other physical impairments influencing gait. Assessments: Gait recovery measured at 6 and 12 weeks (mobilization and weight-bearing), and at 3, 6, 9, and 12 months using physical exams (range of motion, stair walking) and three-dimensional gait analysis (temporospatial, kinematics, and kinetics data).

Exclusions:

Pathologic fractures, physical impairments or injuries affecting gait.

Results:

Mobilization: At 6 weeks, 88% of participants used walking aids, and by 12 weeks, 25% did. Stair walking: 69% could walk up and down stairs at 6 weeks, and 100% could by 12 weeks. Gait patterns: At 3 months, some participants showed deviations in gait patterns, but most showed normalization by 6 months. Kinetics and Kinematics: Hip and knee extension moments were decreased up to 6 months compared with controls. Hip extensor muscle work was increased on the fractured side.

Conclusions:

The study found that early recovery in basic performance tests occurred between 6 and 12 weeks post-surgery. Gait patterns normalized by 6 months, providing useful information for guiding the rehabilitation process and understanding recovery timelines.

Relevance:

Limitations:

Perspective:

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