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Paediatric Femur

  • 1.6% of all paediatric fractures

  • Peaks in early childhood and early adolescence

  • All femoral fractures should be referred to orthopaedics

  • ATLS Approach as high energy injury in older children - consider trauma call

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CLASSIFICATION

  • Open/Closed

  • Fracture location- proximal, middle or distal third.

  • Fracture pattern- transverse, spiral, butterfly, comminuted

MECHANISM​

  • In older children high energy mechanism such as RTA is the mechanism in 90%.  Use ATLS approach and consider trauma call.

  • In younger children due to falls.

  • In children <4years up to 30% are associated with Non Accidental Injury

MANAGEMENT

  • Opiate analgesia

  • Refer all to Orthopaedics

  • Put femoral shaft fractures into skin traction- 10% body weight

  • Consider femoral nerve block

  • Assess for other injuries (secondary survey)

  • In non mobile children screen for NAI

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