Femoral fractures in infants: a comparison of Bryant traction and modified Pavlik harness.

Bryant traction is a commonly used method for femoral shaft fractures in children, but many disadvantages have been reported. Pavlik harness with exact clinical effect and fewer complications has gained increasing popularity in resent years. The objective of this study was to evaluate and compare modified Pavlik harness with Bryant traction for infant with a femoral shaft fracture. A retrospective study was performed of 38 infants treated with either modified Pavlik Harness or Bryant traction. All fractures were closed, isolated, and diaphyseal. We analyzed operative and radiographic data, complications, hospital charges, and functional outcome. Twenty-one patients, with a mean age of 5.9 months, were treated with modified Pavlik harnesses. Seventeen infants, with a mean age of 6.3 months, were treated with Bryant tractions. All fractures united within 3-5 weeks. The two cohorts were similar with respect to age, weight, and fracture union time. Four of the seventeen children treated with Bryant tractions had a skin complication that needed second intervention. No similar complications occurred in the modified Pavlik group (p = 0.03). There was a significant difference in hospital stay (modified Pavlik harness 1.4 days versus Bryant traction 17.8 days) and hospital charge (modified Pavlik harness 3209 Yuan versus Bryant traction 3759 Yuan) (p < 0.001). At one year visit, no difference existed between the two groups for standard clinical/functional criteria. There were no malunion, nonunion, or rotational deformities. Nor were there any significant limb length discrepancies, residual angular deformities.