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Treatment options for femoral shaft fractures in children and adolescents

Treatment options for femoral shaft fractures in children and adolescents
Age Treatment
Birth to 24 mo Pavlik harness (newborn to 6 mo)
Immediate spica cast
Traction → spica cast
24 mo to 5 yr Immediate spica cast
Traction → spica cast
External fixation (rare)
Flexible intramedullary rod (rare)
6-11 yr Traction → spica cast
Flexible intramedullary rod
Compression or submuscular plate
External fixation
12 yr to maturity Flexible intramedullary rod
Compression or submuscular plate
Locked intramedullary rod
External fixation
Treatment choices are influenced by the presence of multiple trauma (vs. an isolated femoral shaft fracture) or an open fracture with soft tissue trauma.
Reproduced with permission from: Kasser JR, Beaty JH. Femoral Shaft Fractures. In: Rockwood and Wilkins' Fractures in Children, 6th ed, Beaty JH, Kasser JR (Eds), Lippincott Williams & Wilkins, Philadelphia 2006. Copyright © 2006 Lippincott Williams & Wilkins. www.lww.com.
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