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Response to injury in children with closed femur fractures
Insights
Closed femur fractures in children rarely cause significant blood loss or hypotension. Most children experienced fever, but only a third showed a minor hematocrit drop, indicating minimal internal bleeding.
Area of Science:
- Pediatric Orthopedics
- Trauma Care
- Hematology
Background:
- Femur fractures in children can be associated with significant blood loss.
- Assessing the risk of hemorrhage is crucial for appropriate management.
Purpose of the Study:
- To evaluate vital signs and hematocrit changes in children with isolated closed femur fractures.
- To determine the incidence of hypotension and need for blood transfusion.
Main Methods:
- Prospective monitoring of 50 children with closed femur fractures.
- Serial measurement of vital signs and hematocrit levels.
- Documentation of fever and need for blood replacement.
Main Results:
- No hypotension was observed in any child.
- Only 33% of children showed a measurable hematocrit drop (average 4 points).
- 80% of children exhibited a significant febrile response lasting approximately 4 days.
Conclusions:
- Isolated closed femur fractures in children are generally not associated with significant hemorrhage.
- Fever is a common response to this injury.
- Hypotension or a rapid hematocrit drop warrants investigation for additional bleeding sources.
Abstract:
Fifty children admitted with closed femur fracture as a single major injury were monitored for change in vital signs and hematocrit. Hypotension was not observed. No child required blood replacement. Only 33% of the children had a measurable change in hematocrit, averaging a four-point drop. There was a marked febrile response to injury in 80% of the children which lasted an average of 4 days. Children admitted with femur fractures who develop hypotension or rapid drop in hematocrit should be promptly evaluated for another source of blood loss.