Management of pediatric diaphyseal femur fractures

  • Benton E. HeyworthEmail author
  • Catherine A. Suppan
  • Dennis E. Kramer
  • Yi-Meng Yen
Pediatrics (M Glotzbecker, Section Editor)


A variety of strategies are utilized for management of pediatric diaphyseal femur fractures, depending chiefly on the age of the patient. Other factors that can influence the selection of a technique—which range from skeletal traction with spica casting to immediate spica casting, flexible intramedullary nailing, rigid intramedullary rodding, or plate fixation—are weight, fracture severity, associated injuries, and underlying medical or musculoskeletal conditions. The available evidence regarding technique, outcomes, and complications of the aforementioned treatment options remains largely insufficient, and, at times, conflicting, which contributes to the challenges in management decisions. Considerable controversy has arisen over several topics, particularly the optimal treatment for patients aged 5 to 12 years and accepted standards of treatment. This review is designed to provide perspective for some of the most recent influential literature on pediatric diaphyseal femur fracture treatment in light of established evidence and evolving controversies.


Pediatric femur fracture Diaphyseal femur fracture Hip spica casting Intramedullary nailing Submuscular plating 



BE Heyworth: none; CA Suppan: none; DE Kramer: none; Y. Yen: consultant to Smith and Nephew Endoscopy, Orthopediatrics.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Benton E. Heyworth
    • 1
    Email author
  • Catherine A. Suppan
    • 1
  • Dennis E. Kramer
    • 1
  • Yi-Meng Yen
    • 1
  1. 1.Department of OrthopaedicsChildren’s Hospital BostonBostonUSA

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