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Topic:

Femoral Shaft Fracture

Issue:

Thigh

Category:

Trauma

Title:

Outcomes in Early Versus Delayed Management of Pediatric Femoral Shaft Fractures

Author:

Hidalgo Perea, Sofia BS; Loyst, Rachel A. BS; Botros, Daniel MD; Barsi, James M. MD

Journal:

Journal of Pediatric Orthopaedics

Date:

March 2024

Reference:

44(3): p e238-e241, DOI: 10.1097/BPO.0000000000002598

Level Of Evidence:

III

# of Patients:

137

Study Type:

Retrospective cohort study

Location:

Single Level One Trauma Center

Summary:

This study evaluates whether the timing of surgical intervention (early vs. delayed) for pediatric femoral shaft fractures impacts outcomes such as time to union and return to baseline function.

Methods:

Pediatric patients with femoral shaft fractures, from January 1, 2010 to January 1, 2021, were identified. Two groups were compared: early intervention (treated within 24 hours) vs. delayed intervention (treated after 24 hours). Demographics, surgical details, associated injuries, length of follow-up, time to union, and return to baseline function were collected. Exclusion criteria: neuromuscular disease, pathologic fractures, slipped capital femoral epiphysis, nonambulatory, under 6 months old, or follow-up of less than 8 weeks. Statistical analysis: χ² test and unpaired Student t test.

Exclusions:

Neuromuscular disease, pathologic fracture, slipped capital femoral epiphysis, nonambulatory, age under 6 months, or follow-up <8 weeks post-treatment.

Results:

Demographics: Mean age: 8.0 ± 5.0 years (range: 6 months to 16 years). Average follow-up: 1.4 ± 1.4 years. Groups: 122 patients in the early intervention group (89%). 15 patients in the delayed intervention group (11%). Outcome Comparison: No significant differences were found between the early and delayed groups in terms of time to union, quality of final reduction, or return to baseline function.

Conclusions:

The timing of surgical intervention (early vs. delayed) for pediatric femoral shaft fractures does not correlate with time to union or return to baseline function. Clinically, prompt surgical treatment should not take precedence over medical resuscitation methods, as it is unlikely to influence the final outcome.

Relevance:

Limitations:

Perspective:

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