Fixateur externe-Versorgung von instabilen kindlichen Femurdiaphysenfrakturen: 10-Jahres-Erfahrung

External Fixation of Instabile Pediatric Femoral Shaft Fractures: 10-years Experience. Between 1989 and 2000, 35 children with femoral shaft fractures were treated by unilateral external fixation. The average age was 7.7 years (3-13). Most of the fractures were A-fractures. Mean duration of external fixation was: for A1-fractures (n = 7) 59.1 days (42-107), for A2-fractures (n = 3+ 1 change of treatment strategy) 75.3 days (43-126), for A3-fractures (n = 11) 61.6 days (39-61), for B1-fractures (n = 8 + 1 change of treatment strategy) 54.2 days (43-59), for the B2-fracture (n = 1) 52 days, for B3-fractures (n = 2) 101 days (47-155), for the C3-fracture (n = 1) 101 days. Complications included 4 refractures, 5 pin-tract infects, 2 postoperative malrotations with necessary intervention and 1 fracture dislocation after manipulation. No patient had nonunion or osteomyelitis. Mean follow-up period was 56.8 months (3-134). No child showed a malrotation with necessary intervention. 30 children showed a mean leg lengthening of 0.56 cm (0-2), one child had a leg shortening of 0.5 cm. Most of the children (24/31) performed one or several kinds of sport, the others were not interested in sports before their injury anyway. In our opinion external fixation is an adequate treatment of pediatric femoral shaft fractures.