Skeletal traction for fractures of the femoral shaft in children. A long-term study.

Fifty-four children who had been treated with 90-90 skeletal traction for a fracture of the femoral shaft were examined after an average follow-up of 4.3 years. All of the patients were functioning normally and had a symmetrical range of motion of both hips and knees. A limb-length discrepancy of more than thirteen millimeters was found in three of thirty-nine children who were less than eleven years old and in eight of fifteen who were more than eleven years old. Traction pins that were placed obliquely were associated with a statistically significant (p less than 0.01) and predictable difference in the intercondylar angle (axis of the knee joint) as compared with pins that were placed horizontally. The study showed that pins for skeletal traction should be placed parallel to the axis of the knee joint and that fractures in children who are more than eleven years old should be reduced without overriding.