Pediatric and adolescent ballistic femur fractures: treatment, outcomes, and costs from a level-one trauma center

This series includes a mixture of non-operative, intramedullary nailing, and open reduction internal fixation patients to broadly represent the pediatric ballistic femur fracture population. High union rates, similar time to union, and low complication rates were observed in both pediatric and adolescent cohorts. Subgroup analysis demonstrated no significant differences in outcomes or complications, supporting extrapolation of adult trauma literature to this population. A considerable loss to follow-up was noted, with male sex, lack of insurance, substance use, and non-operative management identified as common risk factors.