FEMORAL-SHAFT FRACTURES IN CHILDREN - INF LUENCE OF TREATMENT PROCEDURES ON THE SOMATIC AND PSYCHOLOGICAL OUTCOME

When treating femoral shaft fractures in children both somatic (axial/ rotational misalignment) and psychological sequelae of the treatment h ave to be taken into consideration. We performed a retrospective study on the somatic and psychological outcome in 38 children under the age of 10 years with femoral fractures from 1989 to 1991. Twenty-four wer e treated conservatively (i.e. by traction), while 14 had surgery. Ave rage time in hospital was significantly shorter in the operative group (9 days) than in the conservative group (37 days). The rate of rotati onal misalignment >10 degrees was 14% after operation and 45% after tr action. Psychological evaluation revealed a positive influence on inte llectual development in 21% of conservatively treated children but the re were disturbances in motor development (37%), family environment (1 7%) and general health (25%) in this group. Operative treatment was su perior in causing no adverse effects in these fields. We therefore rec ommend surgery for femoral fractures in children older than 3 years.