Related Experiment Video
Updated: Aug 26, 2026
Method and Instrumented Fixture for Femoral Fracture Testing in a Sideways Fall-on-the-Hip Position
Published on: August 17, 2017
Are children with femoral fracture haemodynamically unstable?
Robert S Chu1, Gary J Browne, Lawrence T Lam
1Emergency Department, Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW 2145, Australia.
Insights
Pediatric traumatic femoral fractures rarely cause hypovolemic shock. This study found no evidence of hemodynamic instability in children with this injury, suggesting conservative management is often appropriate.
Area of Science:
- Pediatric Traumatology
- Emergency Medicine
- Orthopedic Surgery
Background:
- Traumatic femoral fractures in children can potentially lead to hypovolemic shock.
- Assessing hemodynamic stability is crucial for managing pediatric trauma patients.
Purpose of the Study:
- To evaluate the incidence of hypovolemic shock in pediatric patients with traumatic femoral fractures.
- To determine if femoral fractures in children are associated with significant hemodynamic compromise.
Main Methods:
- Retrospective descriptive study of children with traumatic femoral fractures over 5.5 years.
- Analysis of vital signs (pulse, blood pressure, respiratory rate, capillary refill, mental status) within 4 hours of injury.
- Review of fluid resuscitation, blood transfusion, and intraosseous access records; assessment of initial hemoglobin and hematocrit.
Main Results:
- No evidence of hemodynamic instability was observed in 100 pediatric patients with traumatic femoral fractures.
- No significant differences in vital signs were found between patients who received fluid bolus and those who did not.
- No patients required intraosseous access or fluid resuscitation; only one received a blood transfusion without hemodynamic instability.
Conclusions:
- Children with traumatic femoral fractures do not typically exhibit hemodynamic instability.
- The study suggests that hypovolemic shock is uncommon in pediatric patients with isolated femoral fractures.
Objective:
To assess the occurrence of hypovolaemic shock in children who have sustained traumatic femoral fracture.
Methods:
A retrospective descriptive study was performed on a cohort of children with traumatic femoral fracture presenting over a five and a half year period from 1 January 1996 to 1 July 2001. Selected parameters for analysis included administration of a fluid bolus, as well as all available vital signs within 4 h following injury relating to pulse, systolic blood pressure, respiratory rate, skin capillary refill time and mental status. Fluid and blood transfusion records were examined, as was the need for intraosseous access. Initial haemoglobin and haematocrit results were also obtained.
Results:
There was no evidence for haemodynamic instability in the 100 patients who met the selection criteria when compared with internationally accepted normal vital sign parameters. No significant difference was found in the initial vital signs between patients who received fluid bolus and those that didn't. No patient needed intraosseous access or fluid resuscitation. One patient received blood transfusion without evidence of haemodynamic instability. Haemoglobin and haematocrit values were not significantly decreased. Ninety-two percent of patients in this study had isolated femoral fracture.
Conclusions:
No evidence for haemodynamic instability was found in a cohort of children with traumatic femoral fracture.
