Epidemiological, Therapeutic, and Outcome Profile of Pediatric Femoral Shaft Fractures: A Retrospective Study of 66 Cases
M. Chami *
Department of Pediatric Trauma and Orthopedic Surgery, Mother and Child University Hospital, Mohammed VI University Hospital, Tangier; Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaâdi University, Tangier, Morocco.
A. Boutahar
Department of Pediatric Trauma and Orthopedic Surgery, Mother and Child University Hospital, Mohammed VI University Hospital, Tangier; Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaâdi University, Tangier, Morocco.
T. Ben Tayeb
Department of Pediatric Trauma and Orthopedic Surgery, Mother and Child University Hospital, Mohammed VI University Hospital, Tangier; Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaâdi University, Tangier, Morocco.
H. Abouel Jaoud
Department of Pediatric Trauma and Orthopedic Surgery, Mother and Child University Hospital, Mohammed VI University Hospital, Tangier; Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaâdi University, Tangier, Morocco.
L. Chater
Department of Pediatric Trauma and Orthopedic Surgery, Mother and Child University Hospital, Mohammed VI University Hospital, Tangier; Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaâdi University, Tangier, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Femoral shaft fractures are common in children, and their management depends primarily on age. This study aimed to describe the epidemiological, clinical, therapeutic, and outcome profiles of these fractures at a Moroccan university hospital.
Materials and Methods: A retrospective descriptive study was conducted from January 2023 to June 2025. Children aged 1 month to 16 years treated for a femoral shaft fracture were included. Epiphyseal and metaphyseal fractures and incomplete medical records were excluded.
Results. Sixty-six Patients were Included: 53 boys (80.3%) and 13 girls (19.7%), with a mean age of 8.9 years (range, 1 month–16 years). Domestic accidents and road traffic accidents were the leading mechanisms (33.3% each). Five fractures were open (7.6%), and 22 patients (33.3%) had associated injuries. The middle third of the shaft was involved in 47.0% of cases; five fractures (7.6%) occurred in pathological bone. Elastic stable intramedullary nailing (ESIN) was used in 51.5% of cases, nonoperative treatment in 31.8%, locked intramedullary nailing in 9.1%, external fixation in 4.5%, and plate fixation in 3.0%. Complications included knee stiffness in 6 patients (9.1%), which resolved after rehabilitation, limb-length discrepancy in 4 (6.1%), and superficial infection in 2 (3.0%). No malunion, nonunion, or neurovascular injury was observed.
Conclusion: In our series, femoral shaft fractures predominantly affected boys and mainly resulted from domestic or road traffic accidents. An age-based treatment strategy, with ESIN as the first-line surgical treatment in school-aged children, yielded good outcomes with few complications.
Keywords: Femoral fracture, shaft, child, elastic stable intramedullary nailing, epidemiology