Proximal Tibial 90-90 Traction in Treatment of Children with Femoral-Shaft Fractures

Abstract

The results of skeletal traction for the treatment of eighty-one femoral-shaft fractures in children are described. The traction pin, placed through the proximal end of the tibia, allows traction suspension of the extremity in 90 degrees of flexion at the hip and knee. Position, length, and alignment were easy to obtain, and patient care was very easy. The healing was prompt, and the average time in traction was from three to four weeks followed by a spica cast for an average of from five to six weeks. The average duration of limited activity was from three to four months. In children over ten years old or weighing more than forty-five kilograms, knee pain, angulation, and difficulty in maintaining length were frequent problems. Therefore, 90-90 traction is not recommended for treating such children. No serious complications occurred. Potential complications of treatment were sought, but none was found. Only two significant limb-length inequalities occurred.