Fractured femur (Paediatric)


Considerable force may be associated with a femoral fracture, although this injury may occur after apparently minor twisting.

Assume major traume involved until excluded.

  • Assess ABC and call for help if required
  • Trauma call if in doubt
  • Actively seek/manage shock and other injuries
  • Early analgesia (including Thomas splint)
  • Record neurovascular status


  • Early IN Fentanyl
  • IV access (morphine) will be required at some stage
  • US guided femoral nerve block
  • Allow time (15 min) for a femoral block to work
  • Apply skin traction (You may need gallows traction in smaller children). It is a priority to get the child in traction
  • If there is an obvious femoral fracture the child should be in traction before imaging

Content by Dr Íomhar O'Sullivan. Last reviewedDr ÍOS 11/04/23.