Femur fractures in children

Femur fractures in children

The femur (thigh bone) frequently is injured in children, usually as the result of significant trauma such as a motor vehicle accident or a fall from a height. With proper treatment, most femur fractures heal without permanent problems

Anatomy of the femur

The head of the femur is fairly round and sits within a cup known as the acetabulum. This forms the hip joint. The shaft runs down the thigh and is covered in the front by the quadriceps muscle. At the end by the knee, it flairs and has rounded areas called condyles that form the knee joint with the upper end of the tibia and the patella (or knee cap). There is a growth plate within the femoral head at the top, and also a growth plate at the level of the condyles.

Causes

Sadly, the most common cause of femur fracture in infants under the age of one is child abuse, which makes up as much as 70 percent of the fractures in this age group. Other common causes of femur fracture in children include serious slips and falls and accidents on or around vehicles. Below is a list of frequent causes of femur fractures in children and adolescents:

  • Bicycle accidents
  • Car accidents
  • Contact sports
  • Hard playground falls
  • Pedestrian/vehicle accidents

Symptoms

Symptoms in children may vary greatly depending on the type and severity of the injury. If your child has been in an accident and is exhibiting any or all of the following common symptoms of femur fractures, you should seek medical treatment for your child right away.

  • Intense and ongoing pain
  • Noticeable swelling or deformation in the thigh area
  • Inability to walk or stand
  • Limited range of motion in the knee or hip

Types

There are many different types of femur fractures. Fractures may occur without breaking the skin (called simple or closed fractures), or in more serious injuries the bone may even pierce the skin (called compound or open fractures). Femur fractures are categorized based on several factors:

  • Location – fractures occur in the distal third, middle or proximal area of the thighbone
  • Number – There may be only two fractured parts, or several
  • Position – fractured edges may be displaced or angulated
  • Shape – spiral, oblique or transverse

Treatments

There are various treatments for femur fractures in children, depending on the age of the patient, type of fracture and location in the bone. Infants and toddlers usually can be treated with a spica (body) cast. Older children may require surgery, depending on the severity of the injury and its location. Rods are commonly used to treat femur fractures in older children. Flexible rods inserted into the hollow center of the bone are the most common, but in some cases a solid rod or an external fixator may be appropriate. Children over the age of 12 are more likely to have a femur fracture treated the way an adult would be treated. 

While perfect alignment often is sought in adult patients, children have the advantage of growth and the ability to remodel the bone with time. Thus, your surgeon may leave the bones overlapped or slightly displaced, since with time they will straighten on their own.

A femur fracture is a serious injury. Parents and other caregivers are advised to seek medical treatment for children immediately in cases of femur fractures, and to provide as much information as possible to the physician so that he or she may better treat the injury. The most appropriate treatment option will depend on the type, severity and location of the fracture. Fortunately, most children heal normally with proper medical care and maintenance.

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