Femoral fracture in children (a prospective study of two hundred and four fractures).

A PROSPECTIVE study of 204 femoral fractures in 200 children admitted continuously to a single surgical unit during a period of two years (1979-81), was carried out to determine the adverse effects on the overall outcome of treatment, due to lack of standard orthopaedic equipment to apply low friction traction. There was no case of fracture of the femoral neck, confirming its rarity in children. Left femur was fractured more than the right and middle third shaft was the commonest site. Spiral type of fracture was more common than the transverse or oblique type. Thirty percent of fractures were due to the Road Traffic Accidents while sport injuries were almost the same in number. 32 percent of total cases had other associated injuries, where skull fractures headed the list. To our satisfaction there was no death in this series. The stay in hospital for various different groups ranged from 21 days to 36 days. The average follow-up was 10 months (range 6 months to 2 years). All femoral fractures united and the only noteworthy complications was in two patients at the end of two years, who had residual shortening of upto 1.2 centimetres. The absence of longitudinal overgrowth in our series (a well known complication) may be due to our failure to maintain adequate reduction of the over-riding fragments probably due to the non-availability of the low friction traction appliances. A malposition of femoral fracture in children, to certain limits, should be left to the Nature's kindly help of remodelling the younger bones and surgical intervention should be avoided.