ABSTRACT
Unlike in the elderly population, hip fractures in children are rare and are most commonly the result of high-energy trauma. A trauma evaluation should always be considered to identify other associated injuries, such as head injuries, abdominal injuries, and other fractures. The Delbet classification is used to describe proximal femur fractures and is prognostic for their risk of avascular necrosis and poor outcome. Femoral shaft fractures occur in a bimodal age distribution with peak incidence in toddlers and in adolescents. Treatment of femur fractures in the 6- to 11-year-old age group is usually operative, using flexible nails or a submuscular plate. After a fracture is excluded, the most common causes of traumatic knee effusions in children are anterior cruciate ligament (ACL) tears and patellar dislocations. Tibial spine fractures occur when the ACL is avulsed with a portion of bone at its tibial insertion.
