Femoral fractures in children from 4 years to 10 years: conservative treatment.

Some authors have widened the indications for surgical management of isolated femoral shaft fractures in children between 4 years and 10 years of age. We address this study to evaluate the results of such femoral fractures treated conservatively in 41 children. All fractures were closed, isolated, and diaphyseal. The mean age was 6.5 years (standard deviation, 1.7 years) and the mean follow-up was 2.3 years (standard deviation, 1.7 years). All fractures were managed conservatively with skin traction (mean hospitalization time, 20.7 days), alignment of the fragments was serially followed by X-ray, and a spica cast was applied (9.7 weeks), usually without a general anesthesia. Angular deformity was assessed by measurement of the fracture-site diaphyseal angle as well as by measurement of the interphyseal angle described by Wallace and Hoffman. No significant complications were recorded regarding leg-length discrepancy, deformity, refractures, etc. Mean cost is not a factor in determining method of treatment at our hospital. We feel that this type of fracture in the 4 years to 10 years age group can be safely treated with a conservative approach.