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Treatment of pediatric diaphyseal femur fractures. 2009
Mininder S Kocher, and
Ernest L Sink, and
R Dale Blasier, and
Scott J Luhmann, and
Charles T Mehlman, and
David M Scher, and
Travis Matheney, and
James O Sanders, and
William C Watters, and
Michael J Goldberg, and
Michael Warren Keith, and
Robert H Haralson, and
Charles M Turkelson, and
Janet L Wies, and
Patrick Sluka, and
Kristin Hitchcock
Department of Orthopaedics, Children's Hospital, Boston, MA, USA.
Methods of treating pediatric diaphyseal femur fractures are dictated by patient age, fracture characteristics, and family social situation. The recent trend has been away from nonsurgical treatment and toward surgical stabilization. The clinical practice guideline on pediatric diaphyseal femur fractures was undertaken to determine the best evidence regarding a number of different options for surgical stabilization. The recommendations address treatments that include Pavlik harness, spica casts, flexible intramedullary nailing, rigid trochanteric entry nailing, submuscular plating, and pain management. The guideline authors conclude that controversy and lack of conclusive evidence remain regarding the different treatment options for pediatric femur fractures and that the quality of scientific evidence could be improved for the revised guideline.
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