Session I - Pediatrics & Injury Prevention

Thurs., 10/8/09 Pediatrics & Injury Prevention, Paper #29, 3:09 pm OTA-2009

Comparing Acute Narcotic Requirements of Pediatric Patients with Isolated Femur Fractures: Skeletal vs. Skin Traction

Cameron J. Vanlaningham, MD1 (n); Thomas M. Schaller, MD2 (n);
Christopher Wise, MD3 (n);
1Michigan State University/Kalamazoo Center for Medical Studies, Kalamazoo, Michigan, USA;
2Orthopaedic Trauma Surgery, HealthCare Midwest, Kalamazoo, Michigan, USA;
3Orthopaedic Trauma Surgery, DFP Orthopedics, Independence, Missouri, USA

Purpose: Pediatric patients with femoral shaft fractures are often placed in traction as a temporizing measure prior to definitive management. The purpose of our study was to compare the narcotic use in pediatric patients with isolated femoral shaft fractures who were initially treated with skeletal traction with similar patients who were initially treated with skin traction. The hypothesis was that narcotic use would not be significantly different between the groups.

Methods: Chart review at 2 institutions was carried out to identify pediatric patients with isolated femoral shaft fractures treated in either skeletal traction or skin traction. The patients’ age, weight, and amount and duration of narcotic use were recorded. A 2-sample t test was used for the comparison.

Results: There were 51 patients treated in skin traction and 24 patients treated in skeletal traction. Patients in the skeletal traction group used more pain medication (0.0177 mg/kg/h in traction) than those in the skin traction group (0.0137 mg/kg/h in traction), but this was not statistically significant (P = 0.1031).

Conclusions: The findings support our hypothesis that the amount of narcotic used between the skeletal traction group and skin traction group would not be significantly different. In using narcotic requirement as a gross measure of patient comfort while in traction, it seems there may be no benefit to patients of having invasive skeletal traction while awaiting definitive management of their fracture.

Disclosure: (n=Respondent answered 'No' to all items indicating no conflicts; 1=Board member/owner/officer/committee appointments; 2=Medical/Orthopaedic Publications; 3=Royalties; 4=Speakers bureau/paid presentations; 5A=Paid consultant or employee; 5B=Unpaid consultant; 6=Research or institutional support from a publisher; 7=Research or institutional support from a company or supplier; 8=Stock or Stock Options; 9=Other financial/material support from a publisher; 10=Other financial/material support from a company or supplier).

• The FDA has not cleared this drug and/or medical device for the use described in this presentation   (i.e., the drug or medical device is being discussed for an “off label” use).  ◆FDA information not available at time of printing. Δ OTA Grant