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Femoral-Shaft Fractures in Children and Adolescents

University of Tennessee College of Medicine, and Director of the Orthopaedic Residency Program, Department of Orthopaedic Surgery, University of Tennessee-Campbell Clinic, Memphis.

Femoral-shaft fractures are frequent in children and adolescents. Fortunately, most unite rapidly without significant complications or sequelae. Treatment options include spica casting, traction, external fixation, compression plating, and flexible or locked intramedullary nailing, each of which has advantages and dis-advantages. Treatment is determined primarily on the basis of the age of the patient and the presence of associated injuries, but psychological, economic, and environmental factors also must be considered. The appropriate treatment can be determined only by careful consideration of all factors and close consultation with the family. Meticulous attention to technical details will help decrease the incidence of complications from both nonoperative and operative treatment.