ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2016
Femoral shaft fractures in young children (<5 years of age): operative and non-operative treatments in clinical practice.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 41 citations in OpenAlex.
- Clinical Efficacy of Minimally Invasive Elastic Stable Intramedullary Nailing for Limb Long Bone Fractures in Children.Orthopaedic surgery · 2021Trial
- The "Bergamo Approach" for Pediatric and Adolescent Polytrauma-A One-Center Experience.Children (Basel, Switzerland) · 2025Article
- Article
- Pediatric femoral shaft fractures: the American Academy of Orthopaedic Surgeons clinical practice guidelines versus actual management in a teaching hospital.Translational pediatrics · 2024Article
- Closed reduction and intramedullary nails for acute completely displaced femoral diaphysis fracture in children aged 2-6.Frontiers in pediatrics · 2024Article
- Trends in the Management of Femur Fractures in Young Children.Journal of the Pediatric Orthopaedic Society of North America · 2023Article
- Suitability of skin traction combined with braces for treating femoral shaft fractures in 3-5 years old children.Journal of orthopaedic surgery and research · 2023Article
- ESIN in femur fractures in children under 3: is it safe?European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Therapy preference of 131 parents confronted with a pediatric femoral fracture.Frontiers in pediatrics · 2022Article
- The Bisaccia and Meccariello technique in pediatric femoral shaft fractures with intramedullary titanium nail osteosynthesis linked external-fixator (IOLE): validity and reliability.Acta bio-medica : Atenei Parmensis · 2021Article
- [Diaphyseal and metaphyseal femoral fractures in childhood].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2021Article
- Risk factors for refracture of the femoral shaft in children after removal of external fixation.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2021Article
- Surveillance ultrasonography for conservative treatment of femoral shaft fractures in young children.Journal of orthopaedic surgery and research · 2020Article
- TREATMENT OF PEDIATRIC FEMORAL FRACTURES IN THE CITY OF ZAGREB.Acta clinica Croatica · 2020Article
- Elastic Stable Intramedullary Nailing for Treatment of Pediatric Femoral Fractures; A 15-Year Single Centre Experience.Bulletin of emergency and trauma · 2019Article
- Systematic review of spica casting for the treatment of paediatric diaphyseal femur fractures.Journal of children's orthopaedics · 2018Article
- [Fractures of the lower extremities in childhood : Part 1: fractures of the thigh and in the proximity of the knee].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2017Article
- Titanium elastic nailing in diaphyseal femoral fractures of children below six years of age.World journal of orthopedics · 2017Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFemoral shaft fractures comprise around 4 % of all long-bone fractures in childhood. There is controversy about the treatment of fractures in children below 5 years, between those preferring non-operative methods, such as casting or traction, and those supporting elastic stable intramedullary nailing (ESIN).
methodsThis retrospective study evaluates the day-by-day treatment of femoral shaft fractures in children aged 6-60 months in four major paediatric surgery trauma centres in Germany from 1 January 2004 to 31 December 2011 by chart review. We analysed all patient-related data, causes of fracture, fracture type, treatment method and potential post-treatment complications.
resultsWe identified 225 patients (male to female 2:1) with femoral shaft fractures. Around 2/3 of these resulted from falls of less than 1 m or 1-3 m, the most frequent result (>40 %) being a long spiral fracture. All 19 children below 1 year of age were treated by casting or traction. Between the ages of 12 and 24 months (n = 56), different treatment concepts were preferred (1/5 ESIN, 2/5 traction and 2/5 spica casting). Between 24 and 36 months, operative and non-operative therapies were equally distributed. In children older than 36 months (n = 64), most fractures were treated by ESIN: six children by external fixation and 14 by other treatments like spica casting, plate osteosynthesis or a combination of methods. 42 changes of treatment were performed: traction to spica casting or secondary operative treatment and 21 complications occurred (nails left in place for too long, skin defects or wound infections).
conclusionsSpica casting of femoral shaft fractures or, in some cases, traction is still the preferred treatment in the first and second years of life. In the third year, children are treated operatively as well as non-operatively, although now there is no current evidence of better short-term outcomes in operatively treated children. But elastic stable intramedullary nailing is the standard treatment for femoral shaft fractures in children older than 3 years of age.
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