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From the American Academy of Orthopaedic Surgeons

Pediatric Femoral Shaft Fractures

by Jeffrey O. Anglen, MD; John M. Flynn, MD

Pediatric femoral shaft fracture refers to fractures of the diaphysis of the femur. Although the fracture may extend into the metaphysis, it excludes those fractures that are restricted to the area of the bone encompassed by a square with sides equal to the width of the proximal or distal end of the bone. Femoral shaft fractures represent less than 2% of all children?s fractures. They occur 3 times more commonly in boys than girls. The mechanism of injury varies with age group. Although the diagnosis of pediatric femur fracture is usually not difficult, it is important to realize that these are usually high-energy fractures and there is a high incidence of other injury.

A number of nonsurgical and surgical management options exist for treating pediatric femoral shaft fractures. This article reviews these options in detail, including spica casting, flexible intramedullary nailing, and submuscular plate fixation. Video is available.

Keywords: femur fracture, diaphyseal fracture of the femur, broken leg, incidence, mechanism of injury, classification, diagnosis, patient history, physical examination, imaging, radiography, differential diagnosis, management, nonsurgical treatment, spica casting, surgical treatment, surgical techniques, external fixation, intramedullary fixation, plate fixation, indications, contraindications, complications, outcomes, rehabilitation, postoperative care

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