A PROSPECTIVE ANALYSIS OF THE SURGICAL AND CONSERVATIVE MANAGEMENT OF LONG BONE FRACTURES IN PAEDIATRIC POLYTRAUMA PATIENTS WITH A CONCOMITANT HEAD INJURY (MODERATE TO SEVERE)

Objective: Prior to the appointment of a dedicated paediatric orthopaedic consultant at a tertiary referral centre (Feb 1999) the treatment of long bone fractures in paediatric patients with associated head injuries was predominately conservative. Current practice is now for early surgical stabilisation wherever possible. The aim of the study was to assess whether this change in clinical practice had resulted in any alteration in outcome. Design: A prospective analysis of patients admitted to the paediatric intensive care unit between Feb 1996 and Jan 2002. Setting: Leeds General Infirmary Main outcome measures: Duration of ICU admission and time to independent walking was assessed. Results: A total of 37 patients were included in the study.17 patients were treated conservatively and 19 surgically .A reduction of approximately 30% was observed in ICU stay and time to independent walking was observed in those patients that underwent early surgical stabilisation. Conclusions: Early surgical stabilisation of long bone fractures in head injured children allows quicker rehabilitation