Femoral shaft fractures in children
- Kimberly P Stone, MD, MS, MA
Kimberly P Stone, MD, MS, MA
- Associate Professor of Pediatrics
- University of Washington
- Klane White, MD
Klane White, MD
- Associate Professor, Department of Orthopaedics and Sports Medicine
- University of Washington School of Medicine
- Section Editor
- Richard G Bachur, MD
Richard G Bachur, MD
- Section Editor — Pediatric Trauma
- Professor of Pediatrics and Emergency Medicine
- Harvard Medical School
- Deputy Editor
- James F Wiley, II, MD, MPH
James F Wiley, II, MD, MPH
- Senior Deputy Editor — Adult and Pediatric Emergency Medicine
- Senior Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Clinical Professor of Pediatrics and Emergency Medicine/Traumatology
- University of Connecticut School of Medicine
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 .
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].
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- PERTINENT ANATOMY
- MECHANISM OF INJURY
- Infants and toddlers
- Children and adolescents
- CLINICAL FINDINGS AND DIAGNOSIS
- RADIOGRAPHIC ASSESSMENT
- INITIAL TREATMENT
- Child protection
- INDICATIONS FOR ORTHOPEDIC CONSULTATION
- DEFINITIVE CARE
- Nonoperative care
- Operative intervention
- FOLLOW-UP CARE
- RETURN TO ACTIVITIES
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS