ArticleJournal of the Pediatric Orthopaedic Society of North America2025
Practice Pattern Preferences Among Pediatric Orthopaedic Surgeons in North America for the Treatment of Femoral Shaft Fractures.
Article in Journal of the Pediatric Orthopaedic Society of North America, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The treatment of pediatric diaphyseal femur fractures varies based on many factors, and the American Academy of Orthopaedic Surgeons (AAOS) clinical practice guidelines (CPGs) are dependent on the quality and quantity of evidence in the literature. The purpose of this study is to assess current practice patterns in the treatment of femoral shaft fractures among pediatric orthopaedic surgeons to identify areas of variability. Methods: From October 2023 to January 2024, the Pediatric Orthopaedic Association of North America (POSNA) Trauma Quality, Safety, and Value Initiative Committee surveyed North American POSNA members on pediatric femoral shaft fracture treatment. Responses were analyzed based on surgeon age, practice location, and practice type. "Usually" and "occasionally" were considered positive responses; "rarely" and "never" were considered negative responses. Results: Of 1551 eligible members, 226 responded (14.6%), primarily aged 30-49 (56%) and in academic settings (77%). For infants (0-6 months), the Pavlik harness was most common, though usage declined with surgeon age ( Conclusions: There are differences in practice patterns for the treatment of pediatric femoral shaft fractures based on surgeon age, practice location, and practice setting. This study identifies areas of variability in practice patterns where further studies are warranted to inform more evidence-based clinical practice guidelines. Key Concepts: (1)Treatment preferences for diaphyseal femur fractures vary uniquely based on the treating surgeon's age, practice location, and practice type.(2)In general, older surgeons tend to choose from a broader array of treatment options when treating pediatric diaphyseal femur fractures.(3)There are several areas of variability among surgeons in the treatment of pediatric diaphyseal femur fractures, highlighting areas of interest for future outcomes research. Level of Evidence: Level IV.
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