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Updated: Jul 18, 2026
Creating Rigidly Stabilized Fractures for Assessing Intramembranous Ossification, Distraction Osteogenesis, or Healing of Critical Sized Defects
Published on: April 11, 2012
External fixation of pediatric femur fractures with cortical contact
Elizabeth G Matzkin1, Eric L Smith, Andrew Wilson
1The Miriam Hospital, Providence, Rhode Island, USA. ematzki@aol.com
Insights
External fixation with cortical contact effectively treats pediatric femur fractures, minimizing leg-length discrepancy. While generally safe, pin-tract infections are a common complication requiring attention.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Traumatology
Background:
- Pediatric femur fractures require effective stabilization methods.
- External fixation is a common treatment modality.
- Assessing the impact of fixation technique on outcomes is crucial.
Purpose of the Study:
- To evaluate the efficacy of external fixation with cortical contact in pediatric femur fractures.
- To determine the incidence of clinical leg-length discrepancy (LLD) following this treatment.
- To identify associated complications.
Main Methods:
- Retrospective review of 40 pediatric femur fracture cases treated with external fixation.
- All fixators were applied with cortical contact.
- Follow-up averaged 29.4 months.
Main Results:
- 100% of fractures healed, with a mean healing time of 92 days.
- Mean leg-length discrepancy (LLD) was 0.24 cm short.
- Complications included refracture (2.5%) and common pin-tract infections (52.5%).
Conclusions:
- External fixation with cortical contact is an effective treatment for pediatric femur fractures.
- This method effectively limits overgrowth and leads to minimal refractures.
- Pin-tract infections are a frequent complication that warrants careful management.
Abstract:
The cases of 40 pediatric femur fractures treated with external fixation were reviewed to determine whether stabilization with cortical contact resulted in clinical leg-length discrepancy (LLD). Mean follow-up was 29.4 months, mean age was 6.6 years (range, 2-10 years), 25 injuries were isolated, 100% of the fixators were applied with cortical contact, all fractures healed by a mean of 92 days, 72.5% were dynamized before removal, mean LLD was 0.24 cm short, and complications included 1 refracture (2.5%), early removal of 2 loose pins (1.25% of 160 pins), pin-tract infections in 21 patients (52.5%), and 1 LLD (2.5%) of more than 1.0 cm (5.0 cm short). External fixation with cortical contact was an effective treatment for pediatric femur fractures. It limited overgrowth and resulted in few refractures. Pin-tract infections were common.
