Designed and created by Guideline Central in participation with the American Academy of Orthopaedic Surgeons
Treatment of Pediatric Diaphyseal Femur Fractures
Patient Guideline Summary
Publication Date: December 5, 2020
Last Updated: March 3, 2023
This patient summary means to discuss key recommendations from the American Academy of Orthopaedic Surgeons (AAOS) for Pediatric Diaphyseal Femur Fractures.
- The diaphysis is the long, central shaft of the thigh bone.
- This patient summary focuses on children from birth to skeletal maturity (when the bones stop growing).
- This fracture in children under 3 years of age should raise the suspicion of child abuse.
- Infants up to 6 months of age may be treated with either a Pavlik harness or a spica cast for 6 months.
- AAOS recommends early spica casting or traction with delayed spica casting for children aged six months to five years of age with less than a 2 cm of shortening due to the fracture.
- These fractures in children from 5 to 11 years of age may be treated with flexible intramedullary nailing.
- For children age eleven years to skeletal maturity, rigid trochanteric entry nailing, submuscular plating, and flexible intramedullary nailing are treatment options.
- AAOS recommends regional pain management following surgery.
- AAOS suggests waterproof cast liners for spica casts.
- AAOS: American Academy Of Orthopedic Surgeons
American Academy of Orthopaedic Surgeons. Treatment of Pediatric Diaphyseal Femur Fractures Evidence-Based Clinical Practice Guideline. www.aaos.org/pdffcpg. Published December 5, 2020.
The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.