Case Study Pediatric Subtrochanteric Femur Fracture

Adult Proximal Humerus Locking Plate for the Treatment of a Pediatric Subtrochanteric Femoral fracture: A Case study

Pediatric subtrochanteric femur fractures are rare injuries that lead to a high level of satisfactory outcomes after nonoperative treatment in young children and operative treatment in older children and adolescents.1–8 Only limited data have been published on operative treatment of these injuries with reported healing rates of 100% after intramedullary nailing with elastic or rigid nails, external fixation

Case report
An 8 year old , otherwise healthy male child presented to emergency with alleged history of fall from a height of 8-9 feet while playing following which sustained trauma to left hip region and patient was not able to walk and weight bear. On examination revealed tenderness in trochanteric

In older children and adolescents with subtrochanteric femur fractures, surgical fixation has become the treatment of choice, because unsatisfactory radiographic alignment and limb length discrepancy frequently result from nonoperative treatment.4 Furthermore, prolonged traction and spica casting become increasingly difficult in older children and requirea longer in-hospital stay and return to ambulation.4 Several surgical treatment options have been described for pediatric subtrochanteric femur fractures, including intramedullary nailing with elastic or rigid nails, external fixation, and open reduction internal fixation.3–8 Although elastic intramedullary nailing has shown promising results, rigid nailing has been found to carry an increased risk for avascular necrosis of the femoral head in this patient population.4,6,8 Furthermore, given the high loads present at the subtrochanteric level, plating using constructs without angular stability frequently leads to limb length discrepancy and loss of reduction.4 Plate constructs with angular stability such as blade plates and locked plates have however been shown to yield satisfactory