External fixation of pediatric femur fractures

One-hundred and thirty-two children with 139 femur fractures were treated with external fixation from 1984 to 1993. Average age at presentation was 8.97 years. All fractures were followed until union, with an average time of external fixation of 11.4 weeks. There were no nonunions. Of 18 patients with definitive radiographic measurements at 2-year follow-up, 15 patients developed overgrowth (average, 8.7 mm) and three demonstrated shortening (average, 7.7 mm). No patient required treatment for residual leg-length discrepancy. Although pin-tract inflammation was common, pin-tract infection requiring intravenous antibiotics occurred in only six patients (4.5%). No patient developed osteomyelitis. Two fractures (1.4%) were not healed at the time of elective fixator removal, necessitating additional time in the fixator. There were two refractures (1.4%) and one fracture through a healing pin tract after fixator removal (0.7%).