Pediatric femoral fractures: a systematic review of 2422 cases.

BACKGROUND: The incidence of femoral fractures in children comprise 20 per 100,000 yearly in the United States and Europe. The treatment of femoral shaft fractures in the pediatric population remains controversial. The child's age often directs the management. Nonoperative treatment options include functional treatment for the very young, Pavlic harness, skin or skeletal traction, and spica casting. Operative treatment options include closed reduction and external fixation, open reduction and internal plate fixation, closed reduction and minimally invasive plate osteosynthesis (MIPO), and closed reduction and intramedullary nailing with either flexible or rigid nails. The effect of operative versus nonoperative treatment has been the focus of several comparative studies.

OBJECTIVE: To determine the effect of different treatment options on the rate of union, malunion, leg-length discrepancy (LLD), complications, and outcome after femoral shaft fractures in children.