title: Paediatric femoral shaft fractures: what are the concomitant injuries?
abstract: BACKGROUND
  Trauma remains a substantial cause of paediatric morbidity and mortality. Femur fractures are common in children, and frequently are the result of high-energy mechanisms of injury. A complete description of missed injuries in this population has not previously been described.
  
  
  METHODS
  A retrospective chart review of patients presenting to the Alberta Children's Hospital with femoral shaft fractures was performed. Associated injuries, and injuries with delayed diagnosis were recorded.
  
  
  RESULTS
  Twenty-percent of the patients suffered at least one other injury with their femur fracture. Six-percent of injuries had a delayed diagnosis, corresponding to three-percent of the patients reviewed.
  
  
  CONCLUSIONS
  There is a risk of missed injuries in the paediatric patient presenting with a femoral shaft fracture. Paediatric trauma teams and paediatric orthopaedic teams must be aware of this risk to help reduce the incidence of missed injuries. A tertiary trauma survey on children with paediatric femoral shaft fractures may help diagnose missed injuries.
authors.affiliation: Orthopedic Surgery Residency Training Program, University of Calgary, Canada. Electronic address: Andrew.dodd@ucalgary.ca.
authors.forename: Andrew
authors.initials: A
authors.lastname: Dodd
authors.forename: Elizabeth Oddone
authors.initials: EO
authors.lastname: Paolucci
authors.forename: David
authors.initials: D
authors.lastname: Parsons
mesh_terms: D000007:Abdominal Injuries / Q000175:diagnosis* / Q000209:etiology; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D057210:Delayed Diagnosis; D005260:Female; D005264:Femoral Fractures / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D015994:Incidence; D007223:Infant; D015601:Injury Severity Score; D008297:Male; D009102:Multiple Organ Failure / Q000175:diagnosis* / Q000209:etiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014193:Trauma Centers; D016896:Treatment Outcome
keywords: Delayed diagnosis; Epidemiology; Femur fractures; Orthopaedic trauma; Paediatrics; Trauma