Description
This lecture, presented by Emily Baird, focuses on pediatric femoral fractures, specifically highlighting the femoral shaft as the most common type. Baird emphasizes the variety of fracture types and treatment methods available, and reassures attendees that while the options may seem overwhelming, they will leave feeling confident about the topic.
**Key Points Covered:**
1. **Patient Factors**: Age, weight, skeletal maturity, and underlying conditions influence treatment decisions. The prevalence of femoral fractures increases as children begin to walk and once they reach a more adventurous stage around puberty.
2. **Fracture Characteristics**: The location and stability of the fracture are crucial in determining the treatment path. Factors like open fractures and polytrauma also impact decision-making.
3. **Family Involvement**: Parental preferences can affect the choice of treatment, whether that means prioritizing early discharge or comprehensive in-hospital care.
4. **Surgeon Factors**: Experience, available resources, and hospital logistics also play a significant role in managing femoral fractures.
5. **Treatment Options**: Various methods are discussed, including:
- **Pavlik Harness for newborns** experiencing fractures at delivery.
- **Gallow's traction** for younger children, which is a non-invasive way to allow healing through gravity.
- **Balanced traction and spica casts** for older children with stable fractures, aiming for quicker home return.
- **Titanium elastic nails (TENS)** for older children with mid-shaft fractures, providing a minimally invasive surgical option.
- **Plates and screws** for fractures presenting with unstable patterns.
Throughout the talk, Baird emphasizes the importance of thorough assessment and the recognition of potentially non-accidental injuries in young patients, ensuring that the comprehensive management of pediatric fractures also includes considerations for child safety and safeguarding. The lecture concludes with a summary of indicated treatments by age and the crucial reminder to keep non-accidental injury in mind when evaluating traumatic fractures.