Femur fracture (peds): Difference between revisions
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{{Peds top}} [[femur fracture]] | |||
==Background== | ==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== | ==Clinical Features== | ||
*History of trauma | *History of trauma | ||
*Pain, point tenderness, deformity | *Pain, point tenderness, deformity | ||
*Inability to walk/bear weight | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Evaluation== | ==Evaluation== | ||
*Assess for distal pulse, motor, and sensation | |||
*Inspect skin for signs of open fracture | |||
*X-ray femur | |||
==Management== | ==Management== | ||
*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== | ||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:Pediatrics]] | |||
[[Category:Orthopedics]] | |||
Latest revision as of 23:06, 28 November 2019
This page is for pediatric patients. 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