One-hundred and thirty-two children with 139 femur fractures were trea
ted with external fixation from 1984 to 1993. Average age at presentat
ion was 8.97 years. All fractures were followed until union, with an a
verage time of external fixation of 11.4 weeks. There were no nonunion
s. Of 18 patients with definitive radiographic measurements at 2-year
follow-up, 15 patients developed overgrowth (average, 8.7 mm) and thre
e demonstrated shortening (average, 7.7 mm). No patient required treat
ment for residual leg-length discrepancy. Although pin-tract inflammat
ion was common, pin-tract infection requiring intravenous antibiotics
occurred in only six patients (4.5%). No patient developed osteomyelit
is. Two fractures (1.4%) were nor healed at the time of elective fixat
or removal, necessitating additional lime in the fixator. There were t
wo refractures (1.4%) and one fracture through a healing pin tract aft
er fixator removal (0.7%).