External fixation of pediatric femoral fractures

Fifteen pediatric femoral fractures in 14 patients were treated with external fixation using the EBI Orthofix unilateral external fixator. The average patient age was 8.5 years (range, 3-13 years). There were 7 children with multiple injuries and 7 with isolated fractures. The average duration in the fixator was 63 days; average followup was 34 months. All 15 fractures healed without additional operative intervention. Average angulation at the fracture site was 4.4 degrees in the anteroposterior plane (range, 0 degrees-10 degrees) and 4.6 degrees in the lateral plane (range, 0 degrees-11 degrees). There were 5 pin tract infections, all of which resolved with systemic antibiotics. There was 1 case of refracture in a boy with muscular dystrophy. Ten patients had clinically equal leg lengths, 3 patients had < 1 cm of inequality, and 1 patient had a 1.5 cm discrepancy. External fixation is a well-proven technique for managing pediatric femoral fractures in the child with multiple injuries. It is also an effective means of treating isolated femoral fractures in the pediatric population.