Fixator Assisted Internal Fixation of Paediatric Femoral Fractures

Femoral shaft fractures in children are serious injuries requiring hospitalisation. Different fixation methods were described. Aim: We present a novel technique using external fixator to facilitate and control the reduction intraoperatively, which would allow for easier submuscular plate application. Methods: We have retrospectively reviewed five boys and five girls. Polyaxial clamps and rods were applied to the sagittally-oriented bone screws, the reduction was done manually, and the clamps were tightened after achieving the proper alignment. The submuscular plate was applied, then clamps and bone screws were removed. Results: The mean age at surgery was 12 years. The mean body weight was 42 kg. There were six type A fractures, two type B and two type C. The mean preoperative haemoglobin concentration of 12.29 g/dl. No blood transfusion was needed. The operative time averaged 122 minutes, and the mean hospital stay after was 2 days. The patients reported no pain at a mean of 1.6 weeks. All fractures united, without malalignment nor length discrepancy, at a mean of 8.3 weeks (range 6-12 weeks). No wound healing problems nor deep infections happened. Conclusion: External fixator-assisted internal fixation of paediatric femoral fractures would facilitate the accuracy and control of fracture reduction and allow minimally invasive percutaneous osteosynthesis