Management of Lower Extremity Fractures
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.
- Roshan A, Ram S. The neglected femoral neck fracture in young adults: review of a challenging problem. Clin Med Res. 2008;33–9:6. (Open Access).Google Scholar
- 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. https://global-help.org/videos/fractures-of-the-foot-in-children/.