Pediatric Thighbone Fracture

The thighbone (femur) is the largest and the strongest bone in the body. It requires a sudden and forceful impact to sustain a break Commonly, such breaks occur with hard falls, an impact hit while playing sports, a car accident, or child abuse. A broken thighbone is a serious injury and is usually evidenced by severe pain, inability to walk, limited range of motion, and swelling. Other serious injuries may also be present.

If you think your child may have a broken thighbone, call 911 or see your doctor immediately. The fracture may be of several types:

• Displaced—bone pieces are out of alignment
• Closed – skin over the break remains intact
• Open – bone fragments may be piercing the skin

To treat the fracture, the pieces of bone are realigned and held in place for healing. Treatments will depend on the type of fracture, child’s age/weight, and the mechanism of injury. Generally, reduction will occur under general anesthesia.

• Certain thighbone fractures can be manipulated back into place from the outside—closed reduction.
• In some cases, it may helpful to put the child’s leg in a weight and counterweight system (traction) before the bones are realigned. The child will stay in the hospital for several weeks with the leg in a traction device.
• Infants and small children can be fitted with a spica cast immediately or within 24 hours of hospitalization.
• More complicated injuries may need to be surgically realigned with or without implants.
• A young child may be casted for a femur fracture. A displaced break may be treated with internal or external fixation device. An external frame immobilizes the fracture by surgical pins placed above and below the fracture site, with pin care done at home. An internal device is a rod, nailing system or plate secured directly in the bone.
• Adolescents usually need external or internal devices for a femur fracture.