[Interpretation of American Academy of Orthopaedic Surgeons Clinical Practice Guideline on the Treatment of Pediatric Diaphyseal Femur Fractures]. 2017

W Chen, and J Li, and Y Z Zhang
Emergency Center of Trauma, Department of Orthopedic Surgery, the Third Hospital of Hebei Medical University, Orthopedic Research Institution of Hebei Province, Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang 050051, China.

The original guideline on the Treatment of Pediatric Diaphyseal Femur Fractures (PDFF) was developed by the American Academy of Orthopaedic Surgeons (AAOS) in 2009, and the guideline was updated by AAOS in 2015. In this reissue, all recommendations in the original guideline identified as"inconclusive" were removed with seven recommendations reserved and without new recommendations added. The recommendations in the current guideline were listed as follows: (1) Children younger than 36 months with PDFF should be evaluated for child abuse. (2) Pavlik harness or spica cast might be used for infants 6 months and younger with a PDFF. (3) Early spica casting or traction with delayed spica casting could be used for children aged from 6 months to 5 years with a PDFF with less than 2 cm of shortening. (4) Waterproof cast liners might be used for spica casts. (5) Flexible intramedullary nailing might be sugested to treat children aged from 5 to 11 years with PDFF. (6) Rigid trochanteric entry nailing, submuscular plating, and flexible intramedullary nailing might be treatment options for children aged over 11 years to skeletal maturity with PDFF. (7) Regional pain management could be used for patient comfort perioperatively. This paper makes interpretation for this guideline with the aim to provide reference for pediatric surgeons to select appropriate treatment methods for patients with PDFF.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D008297 Male Males
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D005260 Female Females
D005264 Femoral Fractures Fractures of the femur. Femoral Fracture,Fracture, Femoral,Fractures, Femoral
D005593 Fracture Fixation, Internal The use of internal devices (metal plates, nails, rods, etc.) to hold the position of a fracture in proper alignment. Osteosynthesis, Fracture,Fixation, Internal Fracture,Fixations, Internal Fracture,Fracture Fixations, Internal,Fracture Osteosyntheses,Fracture Osteosynthesis,Internal Fracture Fixation,Internal Fracture Fixations,Osteosyntheses, Fracture
D005594 Fracture Fixation, Intramedullary The use of nails that are inserted into bone cavities in order to keep fractured bones together. Intramedullary Nailing,Nailing, Intramedullary,Osteosynthesis, Fracture, Intramedullary,Fixation, Intramedullary Fracture,Fixations, Intramedullary Fracture,Fracture Fixations, Intramedullary,Intramedullary Fracture Fixation,Intramedullary Fracture Fixations,Intramedullary Nailings,Nailings, Intramedullary
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000072161 Orthopedic Surgeons Physicians specializing in medical, surgical, and physical methods used to treat and correct deformities, diseases, and injuries to the skeletal system, its articulations, and associated structures. Orthopedists,Orthopedic Surgeon,Orthopedist,Surgeon, Orthopedic,Surgeons, Orthopedic

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