Fracturas diafisarias del fémur en el niño: actualización en el tratamiento

Abstract

The treatment of diaphyseal femur fractures in children is a subject of great controversy due to the procedures employed in adults not being applicable during the growth period. However, there appears to be some consensus in that the method we choose must lead to shortening the hospital stay, is comfortable for the patient, provides suitable stability to the fracture and has less complications and after effects. There is some unanimity in that the methods of choice should be conservative in children less than 5 years-old (Pavlik harness, early cast), except in complex situations. It is from 6 years to 13 years, the period in which one method or the other that should be discussed more. Nowadays, elastic intramedullary nailing is the method preferred by many authors, particularly for transverse fractures and those located in the middle third, except in cases of great instability. In these situations of comminuted or oblique fractures with monolateral external fixation, the rigid nails introduced from the trochanteric region and percutaneous plating can be a good option. There is currently no method that could be applied to all the different types of fracture. The chosen therapeutic option should be based on the clinical stability of the patient, the characteristics of the fracture, diameter of the medullary cavity and weight of the patient.