Abstract
Aim: To quantify the gait characteristics of the children with a history of treated femoral shaft fracture, and compare the outcome of three different treatment methods (spica cast, plate fixation, and flexible intramedullary nailing) in terms of kinematic and kinetic characteristics of gait.
Material and Methods: Fifteen children (9 boys, 8 girls), admitted to our hospital for unilateral (n=12) and bilateral (n=3) femoral fracture were evaluated in this study. The average age was 9.4 years (range 5–15 years). They were treated by three different methods: spica cast (n=5 ), plate fixation (n= 5), flexible intra-medullary nailing (n= 5). The cases were followed up with an average period of 23 months (6–48 months). At the end of the follow up period quantitative gait analysis was performed using Vicon 370 system with five cameras and two Bertec force plates. For each assessment, a typical walk was selected for each limb on the basis of consistency of time-distance characteristics. Kinematic and kinetic gait characteristics were compared using MANOVA, post hoc Tukey and LSD tests.
Results: Gait characteristics of the patients were significantly different than normal, however, the difference between spica cast, plate fixation, and flexible intra-medullary nailing groups in terms of kinematic and kinetic characteristics of gait were not statistically significant. Older children treated by spica cast showed the best gait characteristics among the others.
Conclusion: Femoral shaft fractures during childhood causes significant deviations of gait characteristics even though treated by spica cast, plate fixation, or flexible intra-medullary nailing. These children need novel treatment options to prevent gait pathologies, and further evaluation to understand the compensatory mechanisms of gait deviations.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
