Arneitz Christoph, Szilagyi Istvan, Lehner Bianca, Kienesberger Bernhard, Gasparella Paolo, Castellani Christoph, Singer Georg, Till Holger
Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria.
Department of Paediatric and Adolescent Surgery, Clinical Center Klagenfurt, Klagenfurt, Austria.
Front Pediatr. 2022 Aug 15;10:949019. doi: 10.3389/fped.2022.949019. eCollection 2022.
The management of femoral fractures in children between 3 and 5 years of age is still vividly debated. Therefore, we aimed to assess the basic attitude of parents if confronted with a hypothetical femoral fracture of their toddler.
Parents of children aged between 12 and 36 months were asked for their preference after receiving detailed information on conservative and surgical treatment of femoral shaft fractures. Furthermore, we obtained information regarding the parents' gender, marital status, medical background, highest level of education and profession in a leading or non-leading position and if any of their children already had undergone any operations. The Freiburg Personality Inventory (FPI-R) questionnaire was used to assess parents' personality traits.
In total, 131 participants were included in this study. The vast majority ( = 116, 88.5%) preferred surgical treatment. The most frequently mentioned reasons for this decision were lack of acceptance, followed by faster reconvalescence, shorter hospital stay, less deformity or growth disorders and less stress on the child. The only reason stated against surgical treatment was the need of general anesthesia. A significantly higher rate of conservative procedures was noticed in self-employed participants and stress was found to significantly influence the treatment decision of the parents toward conservative treatment.
The majority of parents confronted with a hypothetical femoral fracture of their child questioned in this study opted for a surgical approach with elastic stable intramedullary nailing (ESIN). This corresponds with trends toward surgery in these cases in major trauma centers in Europe.
3至5岁儿童股骨骨折的治疗仍存在激烈争论。因此,我们旨在评估家长在面对其幼儿假设性股骨骨折时的基本态度。
在向12至36个月大儿童的家长详细介绍股骨干骨折的保守和手术治疗信息后,询问他们的偏好。此外,我们还获取了有关家长的性别、婚姻状况、医学背景、最高学历、担任领导或非领导职务的职业,以及他们的孩子是否已经接受过任何手术的信息。使用弗莱堡人格问卷(FPI-R)评估家长的人格特质。
本研究共纳入131名参与者。绝大多数(n = 116,88.5%)倾向于手术治疗。做出这一决定最常提到的原因是难以接受保守治疗,其次是康复更快、住院时间更短、畸形或生长障碍更少以及对孩子的压力更小。反对手术治疗的唯一原因是需要全身麻醉。个体经营者选择保守治疗的比例明显更高,并且发现压力会显著影响家长对保守治疗的决策。
在本研究中,面对孩子假设性股骨骨折的大多数家长选择了弹性稳定髓内钉固定术(ESIN)的手术方法。这与欧洲主要创伤中心在这些病例中的手术趋势相符。