DISPLACED FRACTURES OF THE FEMORAL-SHAFT IN CHILDREN - UNIQUE FEATURES AND THERAPEUTIC OPTIONS

The decision analysis for managing femoral shaft fractures in children should include such factors as the possibility of child abuse, overgr owth, and the potential for remodeling. Direct and indirect costs must be understood. Factors to consider in determining treatment include t he age of the child, the extent of the soft tissue injury, and associa ted injuries. Nonoperative methods, universally used in the past to tr eat these injuries, still are indicated, but operative modalities shou ld be considered for a greater number of pediatric femoral fractures. Early enthusiasm for external fixation and rigid intramedullary reddin g has been tempered by a greater awareness of their particular complic ations. The role of flexible intramedullary redding, however, is expan ding.