Femur fracture (peds): Difference between revisions
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{{Peds top}} [[femur fracture]] | |||
==Background== | ==Background== | ||
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