[Pediatric femoral shaft fracture: effect of treatment procedure on results with reference to somatic and psychological aspects].
When treating femoral shaft fractures in children both somatic (axial/rotational misalignment) and psychological sequelae of the treatment have to be taken into consideration. We performed a retrospective study on the somatic and psychological outcome in 38 children under the age of 10 years with femoral fractures from 1989 to 1991. Twenty-four were treated conservatively (i.e. by traction), while 14 had surgery. Average time in hospital was significantly shorter in the operative group (9 days) than in the conservative group (37 days). The rate of rotational misalignment > 10 degrees was 14% after operation and 45% after traction. Psychological evaluation revealed a positive influence on intellectual development in 21% of conservatively treated children but there were disturbances in motor development (37%), family environment (17%) and general health (25%) in this group. Operative treatment was superior in causing no adverse effects in these fields. We therefore recommend surgery for femoral fractures in children older than 3 years.