Pediatric Subtrochanteric Femur Fractures Treated With Open Or Sub Muscular Plating
Journal Title: International Journal of Orthopaedics Traumatology & Surgical Sciences - Year 2017, Vol 3, Issue 1
Abstract
Background: Titanium elastic nailing system has been accepted as a standard modality of treatment for pediatric femur fracture in 5- 12 year age group with excellent results. Subset of patients with fracture in subtrochanteric and supracondylar region have shown higher rate of complications than shaft fractures when treated with titanium elastic nailing system. The purpose of the present study was to retrospectively evaluate the outcomes and complications of Open/submuscular plating of subtrochanteric femur fracture in children and young adolescents. Methods: A total of 30 children aged between 5 to 12 years with subtrochanteric femur fracture treated with open or submuscular plating between 2010-2016 were identified. A fracture that was located within 10% of the total femur length below the lesser trochnater was classified as subtrochanteric fracture.We retrospectively evaluated the outcomes and complications using Flynn TEN scoring criteria.Outcomes were classified as excellent, satisfactory or poor. A major complication was defined as one which requires surgical intervention. Minor complications were defined as one which resolved without surgical intervention. Results: The mean age of the study group was 8.4 yrs with 21 boys and 9 girls. 18(60%) fractures were length stable and 12(40%) were length unstable. No patient had open fracture. Full weight bearing ambulation was achieved at an average of 9 weeks and radiological union at 10.7 weeks. Outcome results were excellent in 24(80%) , satisfactory in 5 (17%) and poor in 1(3%) patients. The major complications were seen in 1 patient and minor complications in 5(17%) patients. Conclusion: Our results indicate that subtrochanteric femur fractures treated with open/submuscular plating show excellent results in majority of patients. Length unstable subtrochanteric femur fractures are best treated with plating methods than titanium elastic nail. Length stable fractures show similar results with plating or tianium elastic nailing system.
Authors and Affiliations
Ravindra Patil, Abdul Azeem
Keywords
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