Paediatric Femur
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1.6% of all paediatric fractures
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Peaks in early childhood and early adolescence
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All femoral fractures should be referred to orthopaedics
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ATLS Approach as high energy injury in older children - consider trauma call
CLASSIFICATION
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Open/Closed
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Fracture location- proximal, middle or distal third.
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Fracture pattern- transverse, spiral, butterfly, comminuted
MECHANISM
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In older children high energy mechanism such as RTA is the mechanism in 90%. Use ATLS approach and consider trauma call.
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In younger children due to falls.
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In children <4years up to 30% are associated with Non Accidental Injury
MANAGEMENT
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Opiate analgesia
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Refer all to Orthopaedics
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Put femoral shaft fractures into skin traction- 10% body weight
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Consider femoral nerve block
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Assess for other injuries (secondary survey)
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In non mobile children screen for NAI