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Treatment of Pediatric Diaphyseal Femur Fractures: External Fixation

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Pediatric Femur Fractures

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Abstract

External fixation is an efficient method to align and stabilize diaphyseal femoral fractures and enable early weight bearing and range of motion. Currently the primary indication for external fixation is in the setting of severe soft-tissue injury. Patients with significant closed-head injuries or multiple extremity injuries may also benefit from early fracture stabilization with an external fixator. Technical tips to the placement of external fixation pins in a child revolve primarily around limiting injury to the growth plate. Perhaps just as important to the application of an external fixation device is post-application pin care. While external fixation may inherently allow for some micromotion at the fracture site, it is important to advance the patients’ axial dynamization via progressive weight bearing to promote callus formation and stability. This should reduce the amount of time needed in the external fixator and decrease the risk of refracture once removed. The most common complications of this procedure include pin track infections and loosening, delayed union or malunion, leg length discrepancy, heterotopic ossification, refracture, and hypertrophic scar formation.

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References

  1. Ombredanne L. L’Osteosynthese Temporaire chex Les Enfants. Presse Med. 1929;52:845–8.

    Google Scholar 

  2. Wagner H. Operative Beinverlangerung. Chirurg. 1971;42:260–6.

    CAS  PubMed  Google Scholar 

  3. Sisk TD. External fixation. Historic review, advantages, disadvantages, complications, and indications. Clin Orthop Relat Res. 1983;180:15–22.

    Google Scholar 

  4. Bryan WJ, Tullos HS. Pediatric pelvic fractures: review of 52 patients. J Trauma. 1979;19(11):799–805.

    Article  CAS  PubMed  Google Scholar 

  5. Spiegel PG, Mast JW. Internal and external fixation of fractures in children. Orthop Clin North Am. 1980;11(3):405–21.

    CAS  PubMed  Google Scholar 

  6. Reff RB. The use of external fixation devices in the management of severe lower-extremity trauma and pelvic injuries in children. Clin Orthop Relat Res. 1984;188:21–33.

    Google Scholar 

  7. Wilkins KE. Changing patterns in the management of fractures in children. Clin Orthop Relat Res. 1991;264:136–55.

    Google Scholar 

  8. Skaggs DL, Leet AI, Money MD, Shaw BA, Hale JM, Tolo VT. Secondary fractures associated with external fixation in pediatric femur fractures. J Pediatr Orthop. 1999;19(5):582–6.

    CAS  PubMed  Google Scholar 

  9. Gregory P, Pevny T, Teague D. Early complications with external fixation of pediatric femoral shaft fractures. J Orthop Trauma. 1996;10(3):191–8.

    Article  CAS  PubMed  Google Scholar 

  10. Tolo VT. External skeletal fixation in children's fractures. J Pediatr Orthop. 1983;3(4):435–42.

    Article  CAS  PubMed  Google Scholar 

  11. Alonso JE, Horowitz M. Use of the AO/ASIF external fixator in children. J Pediatr Orthop. 1987;7(5):594–600.

    Article  CAS  PubMed  Google Scholar 

  12. Aronson J, Tursky EA. External fixation of femur fractures in children. J Pediatr Orthop. 1992;12(2):157–63.

    Article  CAS  PubMed  Google Scholar 

  13. Bar-On E, Sagiv S, Porat S. External fixation or flexible intramedullary nailing for femoral shaft fractures in children. A prospective, randomised study. J Bone Joint Surg Br. 1997;79(6):975–8.

    Article  CAS  PubMed  Google Scholar 

  14. Hedin H, Larsson S. Technique and considerations when using external fixation as a standard treatment of femoral fractures in children. Injury. 2004;35(12):1255–63.

    Article  PubMed  Google Scholar 

  15. Hedin H, Hjorth K, Larsson S, Nilsson S. Radiological outcome after external fixation of 97 femoral shaft fractures in children. Injury. 2003;34(4):287–92.

    Article  PubMed  Google Scholar 

  16. Pandya NK, Upasani VV, Kulkarni VA. The pediatric polytrauma patient: current concepts. J Am Acad Orthop Surg. 2013;21(3):170–9.

    PubMed  Google Scholar 

  17. Pape HC, Tornetta III P, Tarkin I, Tzioupis C, Sabeson V, Olson SA. Timing of fracture fixation in multitrauma patients: the role of early total care and damage control surgery. J Am Acad Orthop Surg. 2009;17(9):541–9.

    Article  PubMed  Google Scholar 

  18. Blasier RD, Aronson J, Tursky EA. External fixation of pediatric femur fractures. J Pediatr Orthop. 1997;17(3):342–6.

    CAS  PubMed  Google Scholar 

  19. Evanoff M, Strong ML, MacIntosh R. External fixation maintained until fracture consolidation in the skeletally immature. J Pediatr Orthop. 1993;13(1):98–101.

    Article  CAS  PubMed  Google Scholar 

  20. Probe R, Lindsey RW, Hadley NA, Barnes DA. Refracture of adolescent femoral shaft fractures: a complication of external fixation. A report of two cases. J Pediatr Orthop. 1993;13(1):102–5.

    Article  CAS  PubMed  Google Scholar 

  21. Sola J, Schoenecker PL, Gordon JE. External fixation of femoral shaft fractures in children: enhanced stability with the use of an auxiliary pin. J Pediatr Orthop. 1999;19(5):587–91.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Orthopedic Surgery, Rady Children’s Hospital San Diego, 3030 Children’s Way #410, San Diego, CA, 92123, USA

    Vidyadhar V. Upasani MD & Eric W. Edmonds MD

  2. Department of Orthopedic Surgery, University of California San Diego, San Diego, CA, USA

    Vidyadhar V. Upasani MD & Eric W. Edmonds MD

Authors
  1. Vidyadhar V. Upasani MD
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  2. Eric W. Edmonds MD
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Correspondence to Eric W. Edmonds MD .

Editor information

Editors and Affiliations

  1. Department of Orthopedic Surgery, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts, USA

    Daniel J. Hedequist

  2. Department of Orthopedic Surgery, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts, USA

    Benton E. Heyworth

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Upasani, V.V., Edmonds, E.W. (2016). Treatment of Pediatric Diaphyseal Femur Fractures: External Fixation. In: Hedequist, D., Heyworth, B. (eds) Pediatric Femur Fractures. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-7986-5_8

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  • DOI: https://doi.org/10.1007/978-1-4899-7986-5_8

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  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4899-7984-1

  • Online ISBN: 978-1-4899-7986-5

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