Patients under 4 years old treated with overhead extension for isolated femoral fractures - lessons learned concerning parents' satisfaction.

BACKGROUND: Conservative options are the standard for treatment of femoral fractures for patients under the age of 4 years. We investigated possible factors influencing the satisfaction of the parents in order to improve their experience. PATIENTS: We analyzed 42 cases of children under the age of 4 years treated with overhead extension therapy (OHE) for femoral fracture.
METHODS: Our protocol requires transition to spica cast treatment (SCT) and discharge from the hospital after the initial 10-day OHE. X-rays were analyzed for fracture healing. A pseudonymized questionnaire was sent to the parents in order to evaluate their experiences during the treatment.
RESULTS: The nature of the fracture was explained to 73.3% of the parents in a way that was "understandable and in detail". However, 23.3% stated that "many questions were not answered". Seventy percent of parents noticed behavioral abnormalities during treatment, and 63.3% reported treatment-specific problems. Additionally, 86.7% of parents were satisfied with the therapy outcome, 80% were content with the type of therapy, and 73.3% would choose OHE again. We found a high Spearman correlation between general satisfaction and parents who felt well informed. There was also a strong correlation between high general satisfaction and the opportunity for any problems to be discussed and addressed during the medical rounds. DISCUSSION: The reasons for nonsatisfaction were primarily due to communication problems.
CONCLUSION: Thorough evaluation during medical rounds, communication with healthcare professionals and care provided by the nurses affects the contentment of the families significantly. © Georg Thieme Verlag KG Stuttgart · New York.