Surgical treatment of pediatric femoral shaft fractures.
OBJECTIVE
Femoral shaft fractures are among the most common fractures in children. Depending on the patient's age, fracture location, pattern, mechanism of injury, and associated injuries, several different treatment options exist. The purpose of this review is to discuss these different clinical situations and the recommended treatment methods, as well as to characterize the latest literature and recommendations.


RESULTS
In the past several years, there have been significant changes in the approach to the treatment of pediatric femoral shaft fractures, particularly in school-aged children. Young children have traditionally been treated conservatively with good results, and this method is still currently advocated. Adolescents over the age of 12 are generally treated with rigid intramedullary rods. However, in children between the ages of 5 and 12, new surgical treatment modalities have been tested with good outcomes, and, as new data emerge, these methods are becoming preferable to conservative treatment.


CONCLUSIONS
Children who sustain femoral shaft fractures can present difficult challenges to both orthopedists and pediatricians. A recent shift in treatment in children between ages of 5 and 12 from nonoperative to surgical intervention has led to shorter hospital stays and earlier return to activity with reliable fracture healing.
Gardner
Michael J
MJ
Departmentof Orthopedic Surgery, Hospital for Special Surgery, New York, NY 10021, USA. gardnerm@hss.edu
Lawrence
Brandon D
BD
Griffith
Matthew H
MH
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005592:Fracture Fixation / Q000379:methods*; D006801:Humans; D007223:Infant; D011859:Radiography