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Review
. 2021 Jul;31(5):883-892.
doi: 10.1007/s00590-021-02933-1. Epub 2021 Apr 11.

The clinical features, management options and complications of paediatric femoral fractures

Sean Duffy  1 , Yael Gelfer  2 , Alex Trompeter  2 , Anna Clarke  3 , Fergal Monsell  4
Affiliations
Review

The clinical features, management options and complications of paediatric femoral fractures

Sean Duffy et al. Eur J Orthop Surg Traumatol. 2021 Jul.

Erratum in

Abstract

This article discusses the incidence, applied anatomy and classification of paediatric femoral fractures based on critical appraisal of the available evidence. The aim is to identify techniques that are relevant to contemporary practice whilst excluding the technical details of individual procedures that are beyond the scope of this review. Injuries of the proximal, diaphyseal and distal segments are considered individually as there are considerations that are specific to each anatomical site. Femoral neck fractures are rare injuries and require prompt anatomical reduction and stable fixation to minimise the potentially devastating consequences of avascular necrosis. Diaphyseal fractures are relatively common, and there is a spectrum of management options that depend on patient age and size. Distal femoral fractures often involve the physis, which contributes up to 70% of femoral length. Growth arrest is common consequence of fractures in this region, resulting in angular and length-related deformity. Long-term surveillance is recommended to identify deformity in evolution and provide an opportunity for early intervention. Deliberate injury should be considered in all fractures, particularly distal femoral physeal injuries and fractures in the non-walking child.

Keywords: Complications; Femur; Fracture; Paediatric; Review; Treatment.

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Conflict of interest statement

All authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Delbet type III fracture anatomically reduced and stabilised with a fixed angle locking plate
Fig. 2
Fig. 2
Femoral shaft fractures treated with ESIN (left), MIPO (middle) and a rigid intramedullary nail (right)
Fig. 3
Fig. 3
CT scan and intraoperative image demonstrating a SH III fracture with subsequent screw fixation
See this image and copyright information in PMC

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