Femoral shaft fractures in children: when bone shortening is desirable in healing - abstract

ABSTRACT

Fractures of the femoral shaft are common injuries in growing children. Road traffic accidents, falls from furniture at home and falls from trees account for the majority of cases. Apart from cases of child abuse which should be suspected in toddlers with multiple injuries to the body, pathological fractures are uncommon in this age group. Open fractures are also uncommon. Whereas in the conservative treatment of adult femoral fractures, every attempt must be made to reduce the fragments as accurately as possible and, in particular, restore normal length, in growing children such degree of accuracy in reduction is not necessary. In fact, some degree of bone shortening is desirable in displaced fractures. Accurate reduction of the fragments end to end will result in an overgrowth of the affected limbs amounting to 1" in the femur and this is permanent. This poster presents our experience based on 80 cases treated over an eight-year period. The ages of the children ranged from 3 months to 12 years. All cases were treated conservatively except one eleven-year old who had to be operated on. The only complication observed was a refracture, but this proceeded to proper healing. We believe treatment of fractures of the femoral shaft in growing children, based on certain well deformed principles, should be within the reach of every practitioner. In children approaching adolescence, the potential for growth is limited. Therefore, in these children, the fracture should be managed as for adults (AU)