To determine the efficacy of percutaneous plating for pediatric femoral fractures.

Fourteen children (mean age, 9.1 years-old) with a femoral fracture were treated with minimally invasive percutaneous plating. After a temporary reduction by manual traction or flexible nailing, a plate was inserted into the submuscular plane through proximal or distal incisions of 2-3 cm. Screws were then fixed with the control of the fracture alignment under fluoroscopic guidance. All procedures were carried out without opening the fracture site. The locations of the fracture are as follows: 10 in the middle, 2 in the subtrochanteric, 1 in the proximal, and 1 in the distal area. Seven had a comminution in the fracture, and nine had associated injuries or fractures. According to Flynns criteria, the patients were evaluated after a minimum of 1 year (mean, 2.1 years).

All the fractures united without the need for a bone graft. The mean radiographic healing time was 11.1 weeks (range, 1014 weeks). No residual radiographic frontal or sagittal plane angulation >10 or a leg length discrepancy >5 mm was observed in any patient. No patient showed any limitation in the joint, limping, or implant related problems. All the patients showed excellent final results.

Minimally invasive percutaneous plating is a safe and acceptable surgical option for the treatment of pediatric femoral fractures.