Evaluation of the results of external fixation of femoral shaft fractures in children

ABSTRACT

Thirty-four patients with 35 femoral shaft fractures were treated using the AO unilateral external fixator after reductionfrom 1999 through 2000. Thirteen girls and 21 boys were the material of this study. The average patient age at presentation was 9.5 years [range 6-14 years]. There were 16 children with multiple injuries whereas 18 children had isolated femoral shaft fractures. All the fractures were followed until union, with an average time of external fixation of 75 days. The average follow-up was 1.5 years. All the fractures healed without additional surgical intervention. There was minimal angulation at the fracture site with an average of 4.5 degrees in the anteroposterior plane and 4.6 degrees in the lateral plane. Although pin tract infection was common [10 cases], nine of them resolved with a broad-spectrum oral antibiotics, only one patient required inpatient intravenous antibiotics. No patient developed osteomyelitis. 24 patients had clinically equal leg lengths, 9 patients had clinically less than 10 mm of inequality and only one patient had 15 mm discrepancy. We had no re-fractures after removal of the fixator, We agree with previous reports that external fixation remains a viable option for the treatment of femoral shaft fractures in children with multiple injuries. It is also an effective means of treating isolated femoral shaft fractures in the pediatric population