Submuscular Bridge Plating for Pediatric Femur Fractures

Operative stabilization is the treatment of choice for pediatric femur fractures in patients age ≥5 years to skeletal maturity. The method of stabilization is dependent on many factors, such as age, fracture location, fracture pattern, and surgeon preference. Stabilization can be more challenging for length unstable comminuted and long oblique fracture patterns because of concerns for femoral head avascular necrosis with rigid intramedullary nails and the potential difficulty of stabilizing these complex fractures with elastic intramedullary nails. Submuscular bridge plating restores length and alignment and rigidly stabilizes the unstable pediatric femur fracture. The technique is minimally invasive, “bridges” the fracture leaving the soft tissue intact, and avoids potential avascular necrosis. The technique is described here in detail.