Related Experiment Video
Updated: Jul 14, 2026
Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
Published on: June 6, 2025
Femoral fractures in children, is early interventional treatment beneficial?
S W Sturdee1, P A Templeton, Z Dahabreh
1Department of Orthopaedics and Trauma, The General Infirmary at Leeds, Great George Street, Leeds, West Yorkshire LS1 3EX, United Kingdom.
Insights
Early intervention for pediatric femoral shaft fractures significantly reduces hospital stays. This approach using flexible nails, hip spica, or external fixation benefits children, families, and hospitals.
Area of Science:
- Pediatric Orthopedics
- Trauma Surgery
Background:
- Femoral shaft fractures are common in children.
- Traditional treatment involves prolonged inpatient traction, leading to extended hospital stays.
Purpose of the Study:
- To evaluate the effectiveness of an early intervention protocol for pediatric femoral shaft fractures.
- To compare the length of hospital stay and outcomes between early intervention and traditional treatment groups.
Main Methods:
- A prospective study of 25 children (early intervention group) treated with flexible intramedullary nails, early hip spica, or external fixation.
- A retrospective review of 41 children (traditional treatment group) managed with Gallows or Thomas splint traction.
- Minimum follow-up of 24 months for the early intervention group.
Main Results:
- The early intervention group had a mean hospital stay of 10 nights, compared to 29 nights in the traditional treatment group (p<0.001).
- Malunion rates were slightly higher in the early intervention group at radiological union but largely remodelled within 2 years.
- The early intervention protocol, tailored to the child's age, significantly shortened hospital stays.
Conclusions:
- An early intervention protocol for pediatric femoral shaft fractures leads to significantly shorter hospitalizations.
- This approach offers substantial benefits for patients, families, and healthcare resources.
- Age-dependent application of flexible nails, hip spica, or external fixation is effective.
Abstract:
A protocol of early intervention (flexible intramedullary nails, early hip spica, and external fixation) was started in 1999 and during a 3-year period there were 25 children who sustained a femoral shaft fracture (early intervention group). These were prospectively reviewed with a minimum follow up of 24 months (Range 24-35 months). A historical control group of 41 children was used. These children were injured between February 1996 and February 1999 and were retrospectively reviewed. They had traditional in patient treatments with either Gallows or Thomas splint traction (traditional treatment group). Over the 6-year period from 1996 to 2002 there were a total of 66 femoral shaft fractures in the study that presented to our hospital. The mean length of hospital stay was 29 nights in the traditional group and 10 nights in the early intervention group. This difference is significant (p<0.001). The malunion rate was slightly higher in the early active group at radiological union but most of these remodelled over the 2 years of follow up. The protocol of early intervention used in our institution, of flexible nails, early hip spica or external fixation depended on the age of the child, and has resulted in a shorter hospital stay for the children. This has benefits for the child, the family and the hospital.
Related Concept Videos
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...
01:26Flail Chest-II
Assessment:
1. Clinical Evaluation:
History: