Abstract
Lower limb fractures in children are common. These fractures can be managed in a variety of ways, and the method chosen depends on a number of factors including:
Age of the child.
Site of fracture.
Whether the fracture is open or closed.
Associated injuries.
Surgeon’s expertise and experience.
Parental wishes.
Femur: Immediate or early hip spica gives good results withminimal shortening particularly in the younger child. Flexible IM nails have been widely reported and give good results. It is important to appreciate the mechanics of how the nails function to stabilise the bone and to recognise that pre-bending the nails is a vital step in the operation. As surgeons become more confident in using the nails, the range of indications can be extended to include proximal or distal fractures, comminuted, open and pathological fractures.
Tibia: Skeletal stabilisation of open tibial fractures can be provided by application of an external fixator. The use of flexible IM nails in the tibia is more controversial. Introduction of these nails into the proximal tibia can be difficult and even with pre-bending of the wires, additional cast protection may be required.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
