Injuries associated with fracture of the femur secondary to motor vehicle accidents in children

A retrospective review of the medical records of 149 children < 18 years old who sustained femur fractures secondary to a motor vehicle accident found 159 fractured femurs; 89.3% were closed. One hundred seventy-nine associated injuries occurred in 87 patients (58.4%). Associated fractures were common (50.3%), followed by soft-tissue injuries (18.5%) and head injuries (14%; 3 deaths). The lower limbs were most commonly involved with associated fractures (37.8%), 9 had a "floating knee." The incidence of intra-abdominal injury was 5%, with the liver most commonly lacerated followed by the spleen and intestine. Forty-seven children (43.1%) developed 1 or more complications. The Pediatric Trauma Score ranged from -3 to 11 (73.8% scored > or = 8, while 26.2% scored < 8). Fractures of the femur in children are commonly associated with other injuries, particularly other fractures.