title: Treatment outcomes after insufficiency femoral diaphyseal fractures in nonambulatory children.
abstract: We retrospectively reviewed the treatment and outcomes of diaphyseal femur fractures in a cohort of nonambulatory children. There were 30 patients (38 fractures) reviewed [average age of 10.1 years (range: 1.8-17.8)]. Fractures were treated with locked plate/screw fixation (n=18), with a complication rate of 24% (9/38). Patients with elastic stable intramedullary nailing experienced the highest complication rate (5/7, 71%) compared with plate/screw fixation (2/18, 11%) (P=0.01) and underwent greater subsequent procedures (n=5, 63%). Surgeons should consider locked plate and screw fixation as their first treatment choice in this challenging patient population.
  
  
  METHODS
  III, therapeutic study; retrospective comparative study.
authors.affiliation: Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, Massachusetts, USA.
authors.forename: Benjamin G
authors.initials: BG
authors.lastname: Allar
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Hedequist
authors.forename: Patricia E
authors.initials: PE
authors.lastname: Miller
authors.forename: Michael P
authors.initials: MP
authors.lastname: Glotzbecker
authors.forename: Samantha A
authors.initials: SA
authors.lastname: Spencer
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Shore
mesh_terms: D000293:Adolescent; D001858:Bone Nails; D001860:Bone Plates; D001863:Bone Screws; D002648:Child; D002675:Child, Preschool; D004548:Elasticity; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005269:Femur / Q000601:surgery; D005592:Fracture Fixation / Q000379:methods*; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome