Flexibility in fixation: an update on femur fractures in children

Although non-operative strategies remain a viable option for the management of some children's femur fractures, surgical management has become more popular and predictable, with potential complications better recognized and thus more easily avoided. This paper addresses the operative management of children's femur fractures highlighting the multiple techniques available to treat the spectrum of pediatric femur fractures. We present the applications of Elastic Stable Intramedullary Nailing and Locked intramedullary nailing, sub-muscular or open plating, and external fixation, and discuss the relative advantages and shortcomings of each technique. Cases are presented for illustration.