Femur fracture (peds): Difference between revisions
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''For adult patients see [[Femur fracture]]'' | ''For adult patients see [[Femur fracture]]'' | ||
==Background== | ==Background== | ||
*Bimodal distribution | *Bimodal distribution | ||
**Toddlers: Most common mechanism | **Toddlers: Most common mechanism is falls | ||
**Adolescents: High energy trauma such as MVA or Auto vs | **Adolescents: High energy trauma such as MVA or Auto vs Ped | ||
* | *Maintain high suspicion for [[child abuse]] (second most common child abuse-related fracture after humerus) | ||
==Clinical Features== | ==Clinical Features== | ||
| Line 10: | Line 11: | ||
*Pain, point tenderness, deformity | *Pain, point tenderness, deformity | ||
*Inability to walk/bear weight | *Inability to walk/bear weight | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Femur fracture types}} | {{Femur fracture types}} | ||
| Line 18: | Line 20: | ||
*Assess for distal pulse, motor, and sensation | *Assess for distal pulse, motor, and sensation | ||
*Inspect skin for signs of open fracture | *Inspect skin for signs of open fracture | ||
* | *X-ray femur | ||
==Management== | ==Management== | ||
*Ortho consult in ED | *Ortho consult in ED | ||
**In general, femur fractures in children >6mo require surgical repair | |||
==Disposition== | ==Disposition== | ||
*Admit | |||
==See Also== | ==See Also== | ||
*[[Child abuse]] | |||
*[[Femur fracture]] | |||
==External Links== | ==External Links== | ||
Revision as of 23:30, 21 May 2018
For adult patients see Femur fracture
Background
- Bimodal distribution
- Toddlers: Most common mechanism is falls
- Adolescents: High energy trauma such as MVA or Auto vs Ped
- Maintain high suspicion for child abuse (second most common child abuse-related fracture after humerus)
Clinical Features
- History of trauma
- Pain, point tenderness, deformity
- Inability to walk/bear weight
Differential Diagnosis
Femur Fracture Types
Proximal
- Intracapsular
- Extracapsular
Shaft
- Mid-shaft femur fracture (all subtrochanteric)
Pediatric limp
Hip Related
- Acute rheumatic fever
- Developmental dysplasia of hip
- Femur fracture
- Juvenile idiopathic arthritis
- Legg-Calve-Perthes disease
- Septic arthritis of the hip (peds)
- Lyme disease arthritis
- Slipped capital femoral epiphysis
- Transient (toxic) synovitis
- Osteosarcoma
Other Causes of Limping
- Developmental dysplasia
- Fracture
- Toddler's fracture
- Tillaux fracture, adolescent
- Neoplasm:
- Leukemia
- Ewings
- Osteogenic sarcoma
- Metastatic neuroblastoma
- Osteomyelitis
- Myositis
- Other:
Evaluation
- Assess for distal pulse, motor, and sensation
- Inspect skin for signs of open fracture
- X-ray femur
Management
- Ortho consult in ED
- In general, femur fractures in children >6mo require surgical repair
Disposition
- Admit