Advertisement

LO SCALPELLO-OTODI Educational

, Volume 32, Issue 3, pp 303–308 | Cite as

Le fratture diafisarie del femore

  • Michele MazziEmail author
  • Andrea Micaglio
  • Roberto Schiavon
Aggiornamenti
  • 80 Downloads

Femoral shaft fracture in children

Abstract

Paediatric femoral shaft fractures account for less than 2% of all fractures in children. Modalities of treatment vary mostly according to age, with fracture pattern and site having a lesser impact. There appears to be some consensus in that the method we choose must lead to shortening the hospital stay, be comfortable for the patient, provide suitable stability to the fracture and have less complications. Trends in treatment have varied over time. Significant complications are relatively rare. Because of the limited rotational remodelling it is important to avoid malrotation.

Notes

Conflitto di interesse

Gli autori Michele Mazzi, Andrea Micaglio e Roberto Schiavon dichiarano di non avere alcun conflitto di interesse.

Consenso informato e conformità agli standard etici

Tutte le procedure descritte nello studio e che hanno coinvolto esseri umani sono state attuate in conformità alle norme etiche stabilite dalla dichiarazione di Helsinki del 1975 e successive modifiche. Il consenso informato è stato ottenuto da tutti i pazienti inclusi nello studio.

Human and Animal Rights

L’articolo non contiene alcuno studio eseguito su esseri umani e su animali da parte degli autori.

Bibliografia

  1. 1.
    Sahlin Y (1990) Occurrence of fractures in a defined population: a 1-year study. Injury 21(3):158–160 CrossRefGoogle Scholar
  2. 2.
    McCartney D, Hinton A, Heinrich SD (1994) Operative stabilization of pediatric femur fractures. Orthop Clin N Am 25(4):635–650 Google Scholar
  3. 3.
    Rewers A, Hedegaard H, Lezotte D et al. (2005) Childhood femur fractures, associated injuries, and sociodemographic risk factors: a population-based study. Pediatrics 115(5):e543–e552 CrossRefGoogle Scholar
  4. 4.
    Joeris A, Lutz N, Blumenthal A et al. (2016) The AO Pediatric Comprehensive Classification of long bone Fractures (PCCF), part II. Acta Orthop.  https://doi.org/10.1080/17453674.2016.1258533 Google Scholar
  5. 5.
    Daly KE, Calvert PT (1991) Accidental femoral fracture in infants. Injury 22(4):337–338 CrossRefGoogle Scholar
  6. 6.
    Blakemore LC, Loder RT, Hensinger RN (1996) Role of intentional abuse in children 1 to 5 years old with isolated femoral shaft fractures. J Pediatr Orthop 16(5):585–588 CrossRefGoogle Scholar
  7. 7.
    Coffey C, Haley K, Hayes J, Groner JI (2005) The risk of child abuse in infants and toddlers with lower extremity injuries. J Pediatr Surg 40(1):120–123 CrossRefGoogle Scholar
  8. 8.
    John R, Sharma S, Raj GN et al. (2017) Current concepts in paediatric femoral shaft fractures. Open Orthop J 11(Suppl 2):353–364 CrossRefGoogle Scholar
  9. 9.
    Flynn JM, Skaggs D (2014) Femoral shaft fractures. In: Flynn JM, Skaggs D, Waters P (eds) Rockwood & Wilkins’ fractures in children. Wolters Kluwer, Philadelphia, pp 987–1026 Google Scholar
  10. 10.
    Kocher MS, Sink EL, Blasier RD (2010) American Academy of Orthopaedic Surgeons clinical practice guideline on treatment of pediatric diaphyseal femur fracture. J Bone Jt Surg, Am 92(8):1790–1792 CrossRefGoogle Scholar
  11. 11.
    Irani RN, Nicholson JT, Chung SM (1976) Long-term results in the treatment of femoral-shaft fractures in young children by immediate SPICA immobilization. J Bone Jt Surg, Am 58(7):945–951 CrossRefGoogle Scholar
  12. 12.
    Staheli LT (1967) Femoral and tibial growth following femoral shaft fracture in childhood. Clin Orthop Relat Res 55(55):159–163 Google Scholar
  13. 13.
    Cassinelli EH, Young B, Vogt M et al. (2005) Spica cast application in the emergency room for select pediatric femur fractures. J Orthop Trauma 19(10):709–716 CrossRefGoogle Scholar
  14. 14.
    Illgen R II, Rodgers WB, Hresko MT et al. (1998) Femur fractures in children: treatment with early sitting SPICA casting. J Pediatr Orthop 18(4):481–487 Google Scholar
  15. 15.
    Miller ME, Bramlett KW, Kissell EU, Niemann KM (1987) Improved treatment of femoral shaft fractures in children. The “pontoon” 90–90 SPICA cast. Clin Orthop Relat Res 219:140–146 Google Scholar
  16. 16.
    McCarthy RE (1986) A method for early SPICA cast application in treatment of pediatric femoral shaft fractures. J Pediatr Orthop 6(1):89–91 CrossRefGoogle Scholar
  17. 17.
    Large TM, Frick SL (2003) Compartment syndrome of the leg after treatment of a femoral fracture with an early sitting SPICA cast. A report of two cases. J Bone Jt Surg, Am 85-A(11):2207–2210 CrossRefGoogle Scholar
  18. 18.
    Madhuri V, Dutt V, Gahukamble AD, Tharyan P (2014) Interventions for treating femoral shaft fractures in children and adolescents. Evid-Based Child Health 9(4):753–826 CrossRefGoogle Scholar
  19. 19.
    Tisherman RT, Hoellwarth JS, Mendelson SA (2018) Systematic review of SPICA casting for the treatment of paediatric diaphyseal femur fractures. J Child Orthop 12(2):136–144 CrossRefGoogle Scholar
  20. 20.
    Stannard JP, Christensen KP, Wilkins KE (1995) Femur fractures in infants: a new therapeutic approach. J Pediatr Orthop 15(4):461–466 CrossRefGoogle Scholar
  21. 21.
    Podeszwa DA, Mooney JF III, Cramer KE, Mendelow MJ (2004) Comparison of Pavlik harness application and immediate SPICA casting for femur fractures in infants. J Pediatr Orthop 24(5):460–462 CrossRefGoogle Scholar
  22. 22.
    Bryant T (1873) The practice of surgery. American Publishing Co, Philadelphia Google Scholar
  23. 23.
    Ferry AM, Edgar MS Jr (1966) Modified Bryant traction. J Bone Jt Surg, Am 48(3):533–536 CrossRefGoogle Scholar
  24. 24.
    Aronson DD, Singer RM, Higgins RF (1987) Skeletal traction for fractures of the femoral shaft in children. A long-term study. J Bone Jt Surg, Am 69(9):1435–1439 CrossRefGoogle Scholar
  25. 25.
    Ligier JN, Metaizeau JP, Prévot J, Lascombes P (1988) Elastic stable intramedullary nailing of femoral shaft fractures in children. Bone Jt J 70(1):74–77 CrossRefGoogle Scholar
  26. 26.
    Kocher MS, Sink EL, Blasier DR et al. (2009) Treatment of pediatric diaphyseal femur fractures. JAAOS 17(11):718–725 Google Scholar
  27. 27.
    Marengo L (2017) Le fratture diafisarie del femore. In: Canavese F, Andreacchio A, Holveck J (eds) Manuale pratico di traumatologia pediatrica. Griffin, Carimate, pp 132–136 Google Scholar
  28. 28.
    Dietz HG, Schmittenbecher P, Slongo T, Wilkins K (2006) Elastic Stable Intramedullary Nailing (ESIN) in children. AO manual of fracture management. Thieme, New York Google Scholar
  29. 29.
    Fricka KB, Mahar AT, Lee SS, Newton PO (2004) Biomechanical analysis of antegrade and retrograde flexible intramedullary nail fixation of pediatric femoral fractures using a synthetic bone model. J Pediatr Orthop 24(2):167–171 CrossRefGoogle Scholar
  30. 30.
    Lascombes P, Haumont T, Journeau P (2006) Use and abuse of flexible intramedullary nailing in children and adolescents. J Pediatr Orthop 26(6):827–834 CrossRefGoogle Scholar
  31. 31.
    Luhmann SJ, Schootman M, Schoenecker PL et al. (2003) Complications of titanium elastic nails for pediatric femoral shaft fractures. J Pediatr Orthop 23(4):443–447 Google Scholar
  32. 32.
    Moroz LA, Launay F, Kocher MS (2006) Titanium elastic nailing of fractures of thefemur in children. Predictors of complications and poor outcome. J Bone Jt Surg, Br 88(10):1361–1366 CrossRefGoogle Scholar
  33. 33.
    Canavese F, Marengo L, Andreacchio A et al. (2016) Complications of elastic stable intramedullary nailing of femoral shaft fractures in children weighing fifty kilograms (one hundred and ten pounds) and more. Int Orthop 40(12):2627–2634 CrossRefGoogle Scholar
  34. 34.
    Bar-On E, Sagiv S, Porat S (1997) External fixation or flexible intramedullary nailing for femoral shaft fractures in children: a prospective, randomised study. J Bone Jt Surgl, Br 79(6):975–978 CrossRefGoogle Scholar
  35. 35.
    Miner T, Carroll KL (2000) Outcomes of external fixation of pediatric femoral shaft fractures. J Pediatr Orthop 20(3):405–410 Google Scholar
  36. 36.
    Mooney JF (2012) The use of “damage control orthopaedics” techniques in children with segmental open femur fractures. J Pediatr Orthop 21(5):400–403 CrossRefGoogle Scholar
  37. 37.
    Gregory P, Pevny T, Teague D (1996) Early complications with external fixation of pediatric femoral shaft fractures. J Orthop Trauma 10(3):191–198 CrossRefGoogle Scholar
  38. 38.
    Skaggs DL, Leet AI, Money MD et al. (1999) Secondary fractures associated with external fixation in pediatric femur fractures. J Pediatr Orthop 19(5):582–586 Google Scholar
  39. 39.
    Hedequist DJ, Sink E (2005) Technical aspects of bridge plating for pediatric femur fractures. J Orthop Trauma 19(4):276–279 CrossRefGoogle Scholar
  40. 40.
    Sink EL, Hedequist D, Morgan SJ, Hresko T (2006) Results and technique of unstable pediatric femoral fractures treated with submuscular bridge plating. J Pediatr Orthop 26(2):177–181 CrossRefGoogle Scholar
  41. 41.
    Kanlic EM, Anglen JO, Smith DG et al. (2004) Advantages of submuscular bridge plating for complex pediatric femur fractures. Clin Orthop Relat Res 426:244–251 CrossRefGoogle Scholar
  42. 42.
    Abdelgawad AA, Sieg RN, Laughlin MD et al. (2013) Submuscular bridge plating for complex pediatric femur fractures is reliable. Clin Orthop Relat Res 471(9):2797–2807 CrossRefGoogle Scholar
  43. 43.
    Beaty JH, Austin SM, Warner WC et al. (1994) Interlocking intramedullary nailing of femoral-shaft fractures in adolescents: preliminary results and complications. J Pediatr Orthop 14(2):178–183 CrossRefGoogle Scholar
  44. 44.
    MacNeil JA, Francis A, El-Hawary R (2011) A systematic review of rigid, locked, intramedullary nail insertion sites and avascular necrosis of the femoral head in the skeletally immature. J Pediatr Orthop 31(4):377–380 CrossRefGoogle Scholar
  45. 45.
    Shapiro F (1981) Fractures of the femoral shaft in children: the overgrowth phenomenon. Acta Orthop Scand 52(6):649–655 CrossRefGoogle Scholar
  46. 46.
    Verbeek HO (1979) Does rotation deformity, following femur shaft fracture, correct during growth? Reconstr Surg Traumatol 17:75–81 Google Scholar
  47. 47.
    Clark MW, D’Ambrosia RD, Roberts JM (1978) Equinus contracture following Bryant’s traction. Orthopedics 1(4):311–312 Google Scholar
  48. 48.
    Janzing H, Broos P, Rommens P (1996) Compartment syndrome as a complication of skin traction in children with femoral fractures. J Trauma 41(1):156–158 CrossRefGoogle Scholar
  49. 49.
    Dehne E, Kriz FK Jr (1967) Slow arterial leak consequent to unrecognized arterial laceration. Report of five cases. J Bone Jt Surg, Am 49(2):372–376 CrossRefGoogle Scholar
  50. 50.
    Staheli LT (1967) Fever following trauma in childhood. JAMA 199(7):503–504 CrossRefGoogle Scholar
  51. 51.
    Perez A, Mahar A, Negus C et al. (2008) A computational evaluation of the effect of intramedullary nail material properties on the stabilization of simulated femoral shaft fractures. Med Eng Phys 30(6):755 CrossRefGoogle Scholar

Copyright information

© Società Italiana Ortopedici Traumatologi Ospedalieri d’Italia 2018

Authors and Affiliations

  • Michele Mazzi
    • 1
    Email author
  • Andrea Micaglio
    • 2
  • Roberto Schiavon
    • 1
  1. 1.UOS Ortopedia e Traumatologia PediatricaOspedale S. BortoloVicenzaItalia
  2. 2.UOS Ortopedia e TraumatologiaPoliclinico Abano TermeAbano TermeItalia

Personalised recommendations