title: Plate fixation of femoral shaft fractures in multiply injured children.
abstract: A study was done of twelve patients (seven boys and five girls) who, because of multiple injuries or a head injury, had been managed with compression plating of a unilateral or bilateral femoral-shaft fracture at a level-I trauma center from 1986 through 1990. The patients had a total of fifteen fractures. The average age at the time of the injuries was eight years (range, five years to nine years and eleven months). There were nine closed fractures and six open fractures; three of the open fractures were Grade I; two, Grade II; and one, Grade IIIA, according to the criteria of Gustilo et al. Each patient had an average of three associated injuries. All fifteen fractures had healed clinically and radiographically at an average of eight weeks (range, six to twelve weeks) after the operation. There were no infections. Anatomical alignment was obtained in fourteen limbs. One fracture healed with 13 degrees of anterior angulation. The compression plates were removed at an average of ten months (range, three to twenty-four months) after the index operation. At the latest follow-up evaluation (average, twenty-six months; range, eleven to fifty-seven months), no patient had restriction of activities due to the femoral fracture. Scanograms revealed overgrowth of the injured femur averaging 0.9 centimeter (range, 0.3 to 1.4 centimeters) in seven patients who had an uninjured contralateral femur. We believe that plate fixation of the femur is a good treatment option for children who have a femoral shaft fracture and a major head injury or multiple injuries, or both.
authors.affiliation: Department of Orthopaedics, Harborview Medical Center, Seattle, Washington 98104.
authors.forename: P J
authors.initials: PJ
authors.lastname: Kregor
authors.forename: K M
authors.initials: KM
authors.lastname: Song
authors.forename: M L
authors.initials: ML
authors.lastname: Routt
authors.forename: B J
authors.initials: BJ
authors.lastname: Sangeorzan
authors.forename: R M
authors.initials: RM
authors.lastname: Liddell
authors.forename: S T
authors.initials: ST
authors.lastname: Hansen
mesh_terms: D001860:Bone Plates; D002648:Child; D002675:Child, Preschool; D005260:Female; D005264:Femoral Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods*; D005596:Fractures, Closed / Q000601:surgery; D005597:Fractures, Open / Q000601:surgery; D016489:Head Injuries, Closed / Q000150:complications; D006801:Humans; D008297:Male; D009104:Multiple Trauma / Q000601:surgery*; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome