The management of femur fracture is not according to age but on the basis of 4 things as per skeletel trauma in children neonates,
- Intramedullary canal < 5
- Intramedullary canal 5 -10 mm
- Intramedullary canal >10 mm
Undisplaced fracture in neonates are treated in harness whereas unstable in traction (Byrant's) --> refer to book.
Undsiplaced fracture in pts. with canal between 5 -10 mm are treated with hip spica and plating or flexible nailing is considered if the fracture is unstable
Undisplaced fracture in pts. with canal > 10 mm are treated with rigid nails.
Case Example
6 months old boy with history of injury to (R) lower limb in his mother lap, who while falling from bike held boy hard in her lap. X-rays showed displaced fracture of (r) femur shaft wiht 1-2 cm shortening.
This patient was managed with one and a half hip spica application under G/A with immobilisation of hip and knee joint in 90 degree.
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