Femoral Shaft Fractures in Children

Courtesy: Prof Nabil Ebraheim, University of Toledo, Ohio, USA

Femoral shaft fracture in Children

Femur fracture is a common injury and one of the most common reason for paediatric hospitalisation due to an orthopaedic injury.

Treatment depends upon:
1. Fracture pattern
2. Location of fracture
3. Age of patient

Sites of Femoral Fracture can be :
1. Proximal end
2. Shaft
3. Distal end

Femoral shaft fracture treatment according to age groups:

1. 0-6 months : Pavlik harness
2. 6months – 5 years : Closed reduction and immediate Spica cast (watch out for compartment syndrome)
3. 5yrs – 11yrs : based on location and type of fracture

(1) Retrograde intramedullary flexible nails (diaphysis, transverse fracture)
(2) Submuscular plate (comminuted fracture)
(3) External fixator ( contaminated open fracture, polytrauma patients, to control damage in multiple trauma)

4. Age more than 12 years : Lateral entry rigid nail / submuscular plating.

Complications :
1. Leg length discrepancy with overgrowth
2. Compartment syndrome
3. Tibial tubercle growth arrest and genu recurvatum deformity
4. Malalignment.