Functional Bracing for Pediatric Femoral Shaft Fractures

ABSTRACT: Functional femur bracing is an alternative to spica casting in toddlers and preschool-aged patients with femoral shaft fractures. Prefabricated braces can be applied at the bedside quickly with minimal training and without anesthesia. The braces are adjustable to allow optimal positioning...

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Main Authors: Julia S. Sanders, MD, Jonas Owen, MD, Lindsay M. Andras, MD
Format: Article
Language:English
Published: Elsevier 2024-08-01
Series:Journal of the Pediatric Orthopaedic Society of North America
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2768276524009179
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author Julia S. Sanders, MD
Jonas Owen, MD
Lindsay M. Andras, MD
author_facet Julia S. Sanders, MD
Jonas Owen, MD
Lindsay M. Andras, MD
author_sort Julia S. Sanders, MD
collection DOAJ
description ABSTRACT: Functional femur bracing is an alternative to spica casting in toddlers and preschool-aged patients with femoral shaft fractures. Prefabricated braces can be applied at the bedside quickly with minimal training and without anesthesia. The braces are adjustable to allow optimal positioning of the hip in flexion and abduction, as well as alteration as needed based on fracture characteristics and behavior. Hook and loop straps at the waist and leg permit swelling management and hygiene. Hinges allow for early motion and ambulation. This paper discusses the indications, techniques, and recommended follow-up for functional bracing and illustrates clinical results. Key Concepts: (1) Historically, the gold standard for the treatment of femur fractures in children aged 2 to 5 was closed reduction and spica casting. (2) Functional bracing eliminates the need for casting and anesthesia and allows for easy adjustment and patient hygiene. (3) Early results of a randomized controlled trial show equivalent outcomes to spica casting in the treatment of femoral shaft fractures. (4) Brace application involves adjustment of a prefabricated brace to fit the patient, appropriate analgesia, and family education.
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spelling doaj-art-7e6d479a85fd4c10b79d3d3e9ebec2372024-11-21T06:07:01ZengElsevierJournal of the Pediatric Orthopaedic Society of North America2768-27652024-08-018100091Functional Bracing for Pediatric Femoral Shaft FracturesJulia S. Sanders, MD0Jonas Owen, MD1Lindsay M. Andras, MD2Children’s Hospital Colorado, Aurora, CO, USA; Corresponding author: 13123 E 16th Ave, Box 060, Aurora, CO 80045, USA.Children’s Hospital Los Angeles, Los Angeles, CA, USAChildren’s Hospital Los Angeles, Los Angeles, CA, USAABSTRACT: Functional femur bracing is an alternative to spica casting in toddlers and preschool-aged patients with femoral shaft fractures. Prefabricated braces can be applied at the bedside quickly with minimal training and without anesthesia. The braces are adjustable to allow optimal positioning of the hip in flexion and abduction, as well as alteration as needed based on fracture characteristics and behavior. Hook and loop straps at the waist and leg permit swelling management and hygiene. Hinges allow for early motion and ambulation. This paper discusses the indications, techniques, and recommended follow-up for functional bracing and illustrates clinical results. Key Concepts: (1) Historically, the gold standard for the treatment of femur fractures in children aged 2 to 5 was closed reduction and spica casting. (2) Functional bracing eliminates the need for casting and anesthesia and allows for easy adjustment and patient hygiene. (3) Early results of a randomized controlled trial show equivalent outcomes to spica casting in the treatment of femoral shaft fractures. (4) Brace application involves adjustment of a prefabricated brace to fit the patient, appropriate analgesia, and family education.http://www.sciencedirect.com/science/article/pii/S2768276524009179Femur fractureBracingNonoperative
spellingShingle Julia S. Sanders, MD
Jonas Owen, MD
Lindsay M. Andras, MD
Functional Bracing for Pediatric Femoral Shaft Fractures
Journal of the Pediatric Orthopaedic Society of North America
Femur fracture
Bracing
Nonoperative
title Functional Bracing for Pediatric Femoral Shaft Fractures
title_full Functional Bracing for Pediatric Femoral Shaft Fractures
title_fullStr Functional Bracing for Pediatric Femoral Shaft Fractures
title_full_unstemmed Functional Bracing for Pediatric Femoral Shaft Fractures
title_short Functional Bracing for Pediatric Femoral Shaft Fractures
title_sort functional bracing for pediatric femoral shaft fractures
topic Femur fracture
Bracing
Nonoperative
url http://www.sciencedirect.com/science/article/pii/S2768276524009179
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