Treatment options for femoral shaft fractures in children and adolescents

Age	Treatment
Birth to 24 mo	Pavlik harness (newborn to 6 mo)
	Immediate spica cast
	Traction → spica cast
24 mo to 5 yr	Immediate spica cast
	Traction → spica cast
	External fixation (rare)
	Flexible intramedullary rod (rare)
6-11 yr	Traction → spica cast
	Flexible intramedullary rod
	Compression or submuscular plate
	External fixation
12 yr to maturity	Flexible intramedullary rod
	Compression or submuscular plate
	Locked intramedullary rod
	External fixation

Treatment choices are influenced by the presence of multiple trauma (vs. an isolated femoral shaft fracture) or an open fracture with soft tissue trauma.

Reproduced with permission from: Kasser JR, Beaty JH. Femoral Shaft Fractures. In: Rockwood and Wilkins' Fractures in Children, 6th ed, Beaty JH, Kasser JR (Eds), Lippincott Williams & Wilkins, Philadelphia 2006. Copyright © 2006 Lippincott Williams & Wilkins. www.lww.com.

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Treatment options for femoral shaft fractures in children and adolescents