Femoral shaft fractures during childhood

The treatment of femoral shaft fractures in the child is influenced by the anatomophysiological peculiarities of the bone in childhood. The authors report a personal series of 51 fractures treated surgically (Kuntschner, Rush, Kirshner, external fixator), and they analyze the most significant aspects of fractures of the diaphyseal segments during childhood: post-fracture lengthening and the ability for post-fracture malalignment to self-correct. Also considered are the different methods of treatment, emphasizing advantages and disadvantages (from an economical point of view, as well), to emphasize the authors' therapeutic orientation. Under 6-7 years: trans-skeletal traction for 5-6 days, reduction in narcosis without expecting to achieve anatomical reduction, pelvipodalic plaster. Over 10 years: surgical indications are more frequent, until they are the same as those for adults aged over 13-14 years. Between 7 and 10 years of age is a no man's land, where indications for surgery must be made based on the individual surgeon's experience.