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Question

The type of traction shown in the picture below , is used in management of fracture shaft ?

A. Femur.

B. Tibia.

C. Humerus.

D. Ulna.

 

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Correct Answer » A

Explanation

Gallows traction is used for treatment of fracture shaft femur, in infants and children < 2 yrs of age.

Fracture shaft femur in infant and young children

  • It is published that upto one half of infants and young children who sustain femur fractures are victims of child abuse and child abuse occurs in 50 – 80% of children (< 2 years of age) with femoral fracture.
  • Other causes of fracture are osteogenesis imperfecta (blue sclera, hearing loss, multiple fracture), bone tumors (eosinophilic granuloma, aneurysmal bone cyst).
  • Fracture heals within 2 weeks in infant and children upto 2 years of age.

Treatment depends upon the age of the patient : ‑

1. Conservative : – It is the treatment of choice in children.

  1. 0-2 yeas :- Plaster spica or modified Bryant or Gallow’s traction or pavllic harness (< 6 month of age).
  2. 2-10 years : – Split Russel traction
  3. 10-15 years : – 90-90° femoral skeletal traction.

2. Surgical

  • Surgery is done less commonly in children.
  • It is indicated in older children when closed reduction by conservative treatment is not possible.
  • Intramedullar titanium elastic nailing is the surgery of choice.
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