Isolated femoral shaft fractures in children rarely require a blood transfusion

ABSTRACT Background No recent study has examined how a trend toward surgical fixation for pediatric femoral shaft fractures has impacted blood loss and transfusion requirements. The purpose of this study was to determine the factors influencing transfusions in the treatment of pediatric femoral shaft fractures. Methods A retrospective review of patients with femoral shaft fractures treated surgically from 2004 – 2017 at a tertiary pediatric hospital was conducted. Electronic medical records were reviewed for fixation method, additional injuries, blood loss (estimated blood loss (EBL), hemoglobin, hematocrit) and transfusion. The relationship between fixation method with blood loss and transfusion was examined. Two groups were compared, those with and without additional injuries. Additional injuries were defined as additional fractures and/or abdominal, chest, or head injuries. Results 172 patients met criteria. There were 129 patients with isolated femoral shaft fractures and 43 patients with femoral shaftfractures and concomitant additional injuries. The transfusion rate in patients with isolated femoral shaft fractures was 0.8% (1/129) which was significantly lower than in patients with additional injuries; 39.5% (17/43) (p Conclusion Pediatric patients with surgically treated isolated femoral shaft fractures rarely require transfusion (