Wb. Greene, DISPLACED FRACTURES OF THE FEMORAL-SHAFT IN CHILDREN - UNIQUE FEATURES AND THERAPEUTIC OPTIONS, Clinical orthopaedics and related research, (353), 1998, pp. 86-96
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.