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Hong Man Cho,1 Joon Soo Ha,2 Jae Woong Seo,1 Hyun Ju Lee,1 Sun Do Kim,1 Hyochoon Lee,1 Hyung Bae Park31Department of Orthopaedic Surgery, Gwangju Veterans Hospital, Gwangju, Korea; 2Department of Orthopaedics, King’s College Hospital, London, UK; 3Department of Biology, College of Chonbuk National University, Jeonju, KoreaBackground: Transfer fractures in the lower limbs of bedridden and chair-bound nursing home patients can result from trauma induced by the usual lifting, moving, turning, or transferring maneuvers. Treatment entails immobilization for pain control and position change; however, splints/hard casts increase the risk of pressure sores. Therefore, we evaluated the use of a sponge cast.Materials and methods: Between March 2011 and October 2017, 17 patients with a lower limb transfer fracture due to transferring maneuvers in a nursing home were recruited. We evaluated the improvement in pseudo-motion and divided the patients as having bony union, fibrous union, or remaining pseudo-motion. We also investigated the occurrence of pressure sores due to immobilization up until the final follow-up.Results: Femur fractures occurred in 15 patients and lower leg fractures in two. Six of the 15 femur fractures were periprosthetic (four hip arthroplasty and two knee arthroplasty). Pseudo-motion was improved in 15 of 17 cases, within an average of 17.3weeks for the improvement (14–23weeks; bony union: 11 cases and fibrous union: four cases). Pseudo-motion remained in two cases: one periprosthetic fracture around the knee arthroplasty and the other, a femur neck fracture. No pressure sores occurred.Conclusions: A sponge cast appears to be one of the effective treatment options available for bedridden or chair-bound patients with a lower limb fracture due to its low risk of complications and satisfactory clinical results.Keywords: transfer fracture, long bone fracture, conservative treatment, bedridden, immobile patients |
