الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 113 |  |  |
| | | from | 113 | | |
Abstract
emoral shaft fractures are among the most common fractures in children that require hospital admission.The decision to manage a femoral shaft fracture by conservative or operative means is affected by a wide number of variables, which include age and weight of patient, the type of fracture, associated injuries and socioeconomic status of the family.
Length-unstable fractures are defined as complex, comminuted, or spiral femur fractures with > 2cm of shortening. Instability is also recognized when the length of the fracture is longer than the diameter of the femur at the fracture site.Such fractures are fraught with many complications if not perfectly managed. This complications include; leg length discrepancy, frontal and sagittal plane deformities and malrotation.Many conservative and operative methods of treatment were used to manage length-unstable pediatric femur fractures such as traction followed by spica cast, external fixation, intra medullary nailing and open plate fixation.Currently submuscular bridge plating has evolved into an effective treatment option for the management of pediatric femur fractures. The principles of standard submuscular plating are similar to those of external fixation, in which screw fixation is placed directly above and below the fracture site, followed by 2 to 3 screws placed at a distance. The length of the plate used, typically >10 holes, allows for a wide spread between the screws. The long plate increases the working length of the construct and decreases the strain on the plate.