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Characteristics of femur fractures in ambulatory young children
  1. Louise Capra1,2,
  2. Alex V Levin3,
  3. Andrew Howard4,
  4. Michelle Shouldice1
  1. 1Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Ontario, Canada
  2. 2Children’s University Hospital, Temple Street, Dublin 1, Ireland
  3. 3Department of Pediatric Ophthalmology and Ocular Genetics, Wills Eye Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
  4. 4Division of Orthopaedics, The Hospital for Sick Children, University of Toronto, Ontario, Canada
  1. Correspondence to Dr Louise Capra, Children’s University Hospital, Temple Street, Dublin 1, Ireland; louise.kyne{at}


Objectives To determine and identify the characteristics and circumstances of femur fractures in ambulatory young children.

Design and setting Retrospective review of 203 ambulatory children, between 1 and 5 years old, presenting with femur fractures to an urban paediatric hospital over a 10-year period. χ2 And Student's t test were employed for statistical analysis.

Results The mean age was 36.6 months, with 155 (76.2%) being male. The most frequent mechanism of injury was fall from a height (n=62, 30.5%). The highest number of injuries occurred in 2–3-year-olds. The most common history in 1–2-year-olds was stumbling on/over something causing a fall. For 4–5 year olds it was road traffic accidents. Other additional physical findings were infrequent (14.3%) and not suspicious of inflicted injury. Child protective services concluded three of the cases to be likely non-accidental, and four cases were inconclusive but requiring close follow-up. Of these seven children, six occurred in 1–2-year-olds. No distinguishing feature was noted in fracture type or location.

Conclusions Femur fractures can occur with low velocity injury whether from a short fall or twisting/stumbling injury in young healthy ambulatory children.

  • paediatrics
  • accidental
  • non accidental injury
  • paediatric injury
  • fractures and dislocations

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