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Femoral shaft fractures in children

Kimberly P Stone, MD, MS, MA
Klane White, MD
Section Editor
Richard G Bachur, MD
Deputy Editor
James F Wiley, II, MD, MPH


Fractures of the femoral shaft are common childhood injuries and among the most common causes of hospitalization for pediatric orthopedic injuries. The strong blood supply of the femoral shaft allows for rapid healing and generally favorable outcomes. The treatment for femoral shaft fractures varies based upon the child's age and injury with a trend towards operative stabilization.

Femoral shaft fractures in pediatric patients are discussed here. Proximal and distal femur fractures in children are reviewed separately. (See "Hip fractures in children" and "Distal femoral fractures in children".)


Femoral shaft fractures are among the most common diaphyseal fractures in children with an estimated annual incidence of 19 fractures per 100,000 children in the United States [1-4]. They are also the most common pediatric fracture of the femur, accounting for up to 62 percent of all femur fractures [3].

Several observational studies have identified a bimodal age distribution for femoral shaft fractures with peaks in the toddler age group, where falls are the predominant cause of injury, and in the adolescent age group, where motor vehicle collisions cause most of the fractures [2-5]. Across all age groups, boys have higher rates of femoral shaft fractures than girls [2-8].

Mortality from a femur fracture has been estimated at 1 per 600 patients [5], but is most often due to associated injuries sustained as a result of high energy trauma [3].

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Literature review current through: Oct 2017. | This topic last updated: Mar 22, 2017.
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