Complications in the surgical management of femur fractures in children with non-ambulatory cerebral palsy

Children with severe non-ambulatory cerebral palsy (CP) are at high risk of sustaining a pathological femur fracture.1,2 These fractures are rare. In a review of the epidemiology of femur fractures in children from Cape Town, the prevalence of femoral pathological fractures related to cerebral palsy was less than three per cent.³ These patients often have multiple co-morbidities which predispose them to pathological femur fractures.3-6 The gold standard of treatment for these fractures is conservative management with either traction or cast immobilisation. The incidence of complications has been reported as extremely high in a number of studies after surgical management of these fractures.1,7 The objectives of this case report are to discuss the aetiology of these fractures, emphasise the role of conservative management as the gold standard of treatment, and highlight complications of surgical treatment in children with non-ambulatory cerebral palsy.