PAEDIATRIC FEMORAL FRACTURE AND ASSOCIATED INJURIES IN A UNIVERSITY HOSPITAL.

Abstract

Purpose: To determine the epidemiology of femoral fractures in children and their associated injuries. Patients and methods: We reviewed 475 consecutive children admitted over a seven-year period (1992–1999) to a university hospital. Such details were recorded and analysed as – mechanism of injury, ISS, GCS, ICU stay, total hospital stay, operations performed, presence or absence of femoral fracture, complications and mortality.

Results: Out of 475 children admitted, 57 had a femoral fracture (12%). 14 were girls and 43 were boys. The mean age was 5.1 (range 1–14) and the mean ISS was 6.9 (4–36). The mean GCS was 14 (range 5–15).

The commonest cause of injury was a fall from a height 21/57 (37%) followed by road traffic accidents 20/57 (35%), 11 cases were pedestrians. 6 cases were recorded as non-accidental injuries. 8 children underwent operative treatment whereas the rest were treated conservatively. In 36 children the femoral fracture was an isolated injury. The remaining 21 (37%) had 2 or more injuries. The most common associated injury was a head injury of varying severity 10 (50%) followed by fracture tibia 7 (33%) followed by fracture pelvis 4 (19%). Other associated injuries included a splenic laceration, one pancreatic injury, 3 humerus fractures and 3 forearm fractures. None of the children sustained a chest or spinal injury. The mean hospital stay was 22 days (1–67). 4 children were admitted to the intensive care unit (2 had head injuries) and the mean ICU stay was 3 days (2–5). There was no mortality in these series. Two children underwent fasciotomies for tibial compartment syndrome.

Conclusion: The incidence of associated injuries in children with femoral fractures appears to be 35% with head injury being the commonest. The overall prognosis is favourable as seen in these series of patients with nil mortality.