Management of Lower Extremity Fractures

  • David A. SpiegelEmail author
  • Bibek Banskota


A variety of options are available for managing pediatric femur fractures. Treatment is based on the age of the child, mechanism and energy of the injury, personality of the fracture, the availability of implants and imaging, and the surgeon’s experience. Choices include (1) immediate spica casting, (2) traction alone or traction followed by spica, (3) closed or open reduction and intramedullary fixation, (4) open reduction and plating, and (5) external fixation. An average of 9 mm overgrowth is commonly observed in children between 3 and 8 years, and shortening up to 2 cm is commonly accepted in children less than 10 years. Both overlap and angulation can contribute to limb shortening.



The authors would like to acknowledge Dr. Kaye Wilkins for his lifelong dedication to improving the care of children with musculoskeletal injuries and also for his contributions to this chapter in the first edition of this book.

Additional Resources

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  7. Dr. Kaye Wilkins has produced a number of excellent lower extremity trauma videos which are available on u tube and on the Global HELP website.

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Division of Orthopedic Surgery, Children’s Hospital of PhiladelphiaUniversity of Pennsylvania School of MedicinePhiladelphiaUSA
  2. 2.Hospital and Rehabilitation Centre for Disabled Children (HRDC)BanepaNepal
  3. 3.Department of Orthopedic SurgeryB&B HospitalKathmanduNepal
  4. 4.Department of Orthopedic SurgeryThe Hospital and Rehabilitation Center for Disabled Children (HRDC)BanepaNepal

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