Study designs of evaluations included in the review
All studies comparing two or more interventions that included 10 or more participants, e.g. randomised controlled trials (RCTs) and cohort studies. Case reports or case summaries were excluded.
Specific interventions included in the review
Treatments for femoral fractures including different types of traction, early/late application of hip spica cast (including 'pontoon casts', and internal fixations (nails and plates). Interventions were compared with each other. Studies were excluded if they considered the treatment of fractures of the hip or distal femoral growth plate or the treatment of pathologic fractures.
Participants included in the review
Children with femoral fractures including three age groups: preschool (birth to 5yrs), child (6-12yrs) and adolescent (13-18yrs). Studies primarily focusing on patients over 16yrs of age were also excluded. Eight of the studies included in the review considered children of different age groups, three considered only adolescents, two considered children of different ages groups, but only head injured children and two did not provide age criteria. The upper age limit of eligibility varied between 10 and 17yrs.
Outcomes assessed in the review
Time in hospital (days), duration of immobilisation (days), malunion rates (limb-length discrepancy, malangulation and malrotation), average cost (or charges) and complications. Studies that examined the etiology, imaging or pathophysiology of femoral fractures were excluded. Studies were also excluded if they reported exclusively on either the injuries associated with femoral fractures or the complications of treatment.
How were decisions on the relevance of primary studies made?
This is a single author review. The author does not state how the papers were selected for the review, or if any other individuals helped to perform the selection.