• Louise Capra, Alex V Levin, Andrew Howard, and Michelle Shouldice.
• Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Ontario, Canada.
• Emerg Med J. 2013 Sep 1;30(9):749-53.

ObjectivesTo determine and identify the characteristics and circumstances of femur fractures in ambulatory young children.Design And SettingRetrospective 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. χ(2) And Student's t test were employed for statistical analysis.ResultsThe 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.ConclusionsFemur fractures can occur with low velocity injury whether from a short fall or twisting/stumbling injury in young healthy ambulatory children.

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