Pediatric femur fractures pdf download medical books. Comparative study of the outcome of pediatric femur. In the treatment of these injuries, it is important to keep in mind that pediatric femoral fractures differ from adult femoral fractures in several key respects, and these differences affect management. Figure 1 from pediatric diaphyseal femur fractures.
Proximal metaphyseal and diaphyseal humerus fractures. Principles fracture management free download as powerpoint presentation. A variety of strategies are utilized for management of pediatric diaphyseal femur fractures, depending chiefly on the age of the patient. Hence spontaneous, complete correction after fracture healing is expected. Intramedullary nails for pediatric diaphyseal femur. Pediatric diaphyseal femur fractures account for 1. Complications of plate fixation of femoral shaft fractures. In the treatment of these injuries, it is important to keep in mind that pediatric femoral fractures. Fractures using an interlocking pediatric femoral nail and a lateral trocanteric entry point.
The management of paediatric diaphyseal femoral fractures. A marked increase occurs in those over age 75 years. The operative stabilization of pediatric diaphyseal femur. Treatment of pediatric diaphyseal femur fractures case study. Because of this, rapid healing of diaphyseal femur fractures and post fracture skeletal remodeling is maximal. Children with multiple system injuries, a head injury, andor multiple fractures have fewer local and. Treatment of pediatric diaphyseal femur fractures case study introduction isolated pediatric femoral shaft fractures occur at an annual rate of 19 per 100,000 and represent the most frequent pediatric. We evaluated the results of intramedullary stabilization of pediatric diaphyseal femur fractures with elastic ender nails. Left an oblique, displaced fracture of the femur shaft. Principles fracture management major trauma ischemia. 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. Management of pediatric diaphyseal femur fractures.
While multiple surgical options exist for this injury in children older than. According to the current american academy of orthopaedic surgeons aaos clinical practice guidelines. The present study is a imed at the evaluation of intramedullay fixation with ten in children with fe moral fractures. Stabilization of pediatric diaphyseal femur fractures with. The use of submuscular plates for pediatric femur fractures has become more common in the last 10 years. Titanium elastic nails for pediatric femur fractures. The management of paediatric femoral fractures depends primarily on the age of the child although the. Patients demographic data, mode of injury, union rate, and complication rates were evaluated. For humeral diaphyseal fractures which cannot be managed nonoperatively, elastic intramedullary nailing or plate and screw fixation can be used with good outcomes.
Due the rapid union and complete remodeling, treatment of diaphyseal femur fractures centers on assuring ease of patient care and minimizing treatment. Summarythe indications for surgical stabilization of a pediatric diaphyseal femur fracture are expanding. Abstractmethods of treating pediatric diaphyseal femur fractures are dictated by patient age, fracture characteristics, and family social situation. Clinical practice guidelines cpg provide evidencebased recommendations for current orthopaedic diagnostic, treatment, and postoperative procedures. A common treatment for pediatric femur fractures is intramedullary nail imn insertion. Heyworth bringing together the many considerations and complexities surrounding the.
Pediatric femoral shaft fractures are one of the most common peditric orthopaedic fractures and are the most common reason for pediatric orthopaedic hospitalization. Thighbone femur fractures in children ortho 4 states. These psychosocial factors, along with the increasing emphasis toward minimizing the hospital stay and its consequences, have generated interest for the internal and external fixation of pediatric diaphyseal. This study compared the radiographic and clinical outcomes of pediatric diaphyseal femur fractures treated by submuscular plating, flexible retrograde intramedullary nailing, or rigid antegrade. A practical guide to evaluation and management pdf author daniel j. Femoral fractures are among the most common fractures of long bones.
Other factors that can influence the selection of a. Small femoral canal size and proximal and distal femoral epiphyses frequently limit the use of standard adult fracture care. There were four unscheduled reoperations, but no major complications. Femoral shaft fractures, typically caused by blunt trauma, are the most common major pediatric injuries treated by the orthopedic surgeon. Historically, compression plating of fractures of the femoral shaft provided excellent stability and maintenance of length in. Pediatric distal femoral fractures are very unusual 12. This study was done to compare the outcome and complications of diaphyseal femur fractures in pediatric age treated with crif with titanium elastic nails vs. Consequently, a wide range of deformity of the initial healed bone is considered acceptable.
The past decade has seen a trend away from nonsurgical treatment such as. Pdf intramedullary stabilization of pediatric diaphyseal. Because of this, rapid healing of diaphyseal femur fractures and postfracture skeletal remodeling is maximal. Femoral shaft fracture in children not yet walking must raise suspicion for nonaccidental trauma. Treatment of pediatric diaphyseal femur fractures with. Management of pediatric femur fractures with a single semi. Multidisciplinary clinician work groups and aaos staff work together to synthesize published research. Retrospective, multicenter evaluation of complications in. Current concepts in paediatric femoral shaft fractures. Burden of disease there are many components to consider when calculating the overall cost of treatment for pediatric femoral fracture.
Elastic stable intramedullary nails esins are often used for these procedures in heavier patients, but the. Pediatric femoral fractures may involve the proximal femur, the femoral shaft, or the distal femur. Submuscular locked plate for fixation of pediatric. Clinical practice guidelines cpg provide evidencebased recommendations for current orthopaedic diagnostic. Methods of treating pediatric diaphyseal femur fractures are dictated by patient age, fracture characteristics, and family social situation. Pediatric femur shaft fractures tend to unite rapidly and have a tremendous remodelling potential. Retrograde versus antegrade intramedullary nailing of gunshot diaphyseal femur fractures. Treatment depends on the age, fracture pattern, and weight of the patient. Specifically, thighbone fractures are classified depending on. Pediatric femur fractures a practical guide to evaluation and management daniel j.
The pediatric periosteum is extremely strong and thick, functioning in. For pediatric proximal humeral metaphyseal fractures, percutaneous pinning and flexible intramedullary nailing may be necessary, both of which are reported to have good outcomes. The results obtained using flexible intramedullary nails for the stabilization of select pediatric diaphyseal femur. The majority of femur fractures occur in the proximal third ie, hip fractures, which are discussed separately. Abstract purpose this study aims to critically analyze the major and minor complications that may be associated with plate fixation of pediatric diaphyseal femur fractures. Clinical practice guideline on the treatment of pediatric diaphyseal femur fractures. Flexible intramedullary nailing in the treatment of diaphyseal fractures of the femur in preschool children. The entirety of the pediatric femur is considered, including.