Injury
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Femoral shaft fractures are the commonest diaphyseal fractures of childhood after those of the radial and ulnar shaft and the tibial shaft. Common mechanisms include falls, particularly from playground equipment, motor vehicle accidents and sporting injuries. Unlike in adults, femoral shaft fractures are commonly isolated injuries in children. ⋯ The main current controversies are the age at which elastic nailing becomes appropriate instead of conservative management, and secondly, the treatment of the older, heavier child for whom elastic nails may not be appropriate. Familiarity with several methods of femoral shaft stabilisation is appropriate. The major determinant in the choice of treatment is cultural.
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In pediatric pelvic fractures and acetabular fractures, the treating physician is confronted with a unique pattern of injuries. Throughout the literature, pediatric pelvic fractures are rare, but acetabular fractures are even rarer. ⋯ In this article, we review the epidemiology and pathophysiology of this entity of fractures and provide current algorithms for diagnosis and therapy. Both operative and nonoperative treatments have been advocated in the literature, and in this article we define indications for both approaches and review the current literature.