This document can be made available in alternative formats on request for a person with a disability. McRae R, Max Esser M, Practical Fracture Treatment Fifth Edition, Churchill Livingstone, 2008.Kluwer W, Rang's Children's Fractures Fourth edition. Transverse fracture of femur with displacement and shortening References Spiral fracture of femur in a 3 month old which was the result of NAI. Note 'bucket handle' appearance of distal metaphysis Diazepam - Medication Manual (internal WA Health only) orally is useful for muscle spasm and adequate oral analgesia should be provided prior to transfer to the ward. Press the femur breaker button (automated hydraulic press) and wait for SCP-106 to appear.Traction splint should be applied once adequate analgesia has been given and femoral nerve block has been done.Younger children will need traction +/- hip spica and older children may need intramedullary rods to stabilise the fracture.A break or fracture along this length of bone is called a femoral shaft. All femoral shaft fractures should be referred to the Orthopaedic team. The long part of the femur that people consider their thigh is called the femoral shaft. Early referral to the Orthopaedic Team for reduction is important to reduce the incidence of osseous necrosis. Hip dislocation is uncommon in children but may be associated with fracture.Management involves strict bed rest, analgesia and Orthopaedic Team referral for pinning.Slipped Upper (or Capital) Femoral Epiphysis (SUFE) usually presents in adolescents with a history of chronic hip or knee pain but may also present acutely with trauma.All proximal femoral fractures should be referred to the Orthopaedic team.A femur X-ray should have Anterior Posterior (AP) and lateral views and include both the hip and knee joint.įor general assessment and management, see Fractures - Overview.Leg may be shortened and externally rotated.Pain and swelling of the thigh with reluctance to move the hip and knee joints.In children High energy trauma such as sports and motor vehicle accidents.Fall with a twisting injury or direct blow.An intramedullary nail can be inserted into the canal either at the hip or the knee. The rod passes across the fracture to keep it in position. During this procedure, a specially designed metal rod is inserted into the canal of the femur. Clinicians should also consider the local skill level available and their local area policies before following any guideline. Currently, the method most surgeons use for treating femoral shaft fractures is intramedullary nailing. These clinical guidelines should never be relied on as a substitute for proper assessment with respect to the particular circumstances of each case and the needs of each patient. Clinical common-sense should be applied at all times. They are not strict protocols, and they do not replace the judgement of a senior clinician. These guidelines have been produced to guide clinical decision making for the medical, nursing and allied health staff of Perth Children’s Hospital.
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