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Pediatric Femoral Shaft Fracture External Fixation 20690

Pediatric Femoral Shaft Fracture

Pediatric Femoral Shaft Fracture

Pediatric Femoral Shaft Fracture

Pediatric Femoral Shaft Fracture

 

femur bone anatomy

thigh cross section anatomy

Pediatric Femoral Shaft Fracture

Pediatric Femoral Shaft Fracture

synonyms:pediatric femoral shaft fracture external fixation, ex fix

Pediatric Femoral Shaft Fracture Ex Fix CPT

Pediatric Femoral Shaft Fracture Ex Fix Anatomy

Pediatric Femoral Shaft Fracture Ex Fix Indications

  • Multitrauma

Pediatric Femoral Shaft Fracture Ex Fix Contraindications

Pediatric Femoral Shaft Fracture Ex Fix Alternatives

  • ORIF
  • Spica casting

Pediatric Femoral Shaft Fracture Ex Fix Planning / Special Considerations

  • Risks=femoral vessels, femoral nerve, sciatic nerve and its divisions, hip&knee joint
  • Deep femoral vessels and saphenous nerve are most vulnerable as they pass through Hunter’s canal which can extend from the mid-aspect of the femur to the distal 1/6th.
  • Knee joint(suprapatellar pouch) extends anterior @6.3cm above the proximal pole of the patella

Pediatric Femoral Shaft Fracture Ex Fix Technique

  • Sign operative site.
  • Pre-operative antibiotics, +/- regional block.
  • General endotracheal anesthesia
  • Supine position. All bony prominences well padded.
  • Prep and drape in standard sterile fashion.
  • Open Fractures: debrided skin edges sharply, debride all non-viable tissue,, irrigated with at least 9L of fluid.
  • Place pin in longer fragment through 1cm stab incision. Pins are placed laterally just posterior to the vastus lateralis. Pins may be 5mm or 4mm depending on patient size.
  • Irrigate.
  • Close in layers.

Pediatric Femoral Shaft Fracture Ex Fix Complications

  • Leg Length Discrepancy 736.81: overgrowth common in ages 2-10y/o.
  • Infection
  • Delayed union
  • Nonunion
  • Vascular injury
  • Compartment syndrome
  • tibial physeal closure and development of genu recurvatum deformity (Bowler, J Pediatric Orthop 10:653;1990)
  • Painful hardware (pain at flexible nail insertion site)

Pediatric Femoral Shaft Fracture Ex Fix Follow-up care

  • Post-op:
  • 7-10 Days:
  • 6 Weeks:
  • 3 Months:
  • 6 Months:
  • 1Yr:

Pediatric Femoral Shaft Fracture Ex Fix Outcomes

Pediatric Femoral Shaft Fracture Ex Fix Review References

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