Pediatric Femoral Shaft Fractures


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.

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