Pediatric subtrochanteric femur fractures: An innovative technique of fixation using 1/3rd semitubular plate

Volume : VII, Issue : VII, July - 2018

Dr. R. L. Dayama, Dr. Gaurav Garg

Introduction: Proximal subtrochanteric femur fractures are challenging in terms of management due to anatomic constraints, inherent fracture

instability, no direct control of the short proximal fragment, and the close proximity of fracture to the physeal plate. Surgical intervention

results in better outcome with faster healing and less eventual complications. We describe and analyse an innovative method of fixation using

custom bend 1/3rd tubular plate, which we found to be simple and cost effective to use, for treatment of subtrochanteric proximal femur fracture in

pediatric age group patients.

Material and Methods: Nine children were included in the study within the age group of 3–6 years, who sustained subtrochanteric fracture

according to our criteria. Fixation was done with innovative technique of custom bend 1/3rd semitubular plate. Clinical and radiological

assessment includes duration of bone healing, hip and knee range of motion and functional activities.

Results: All fractures healed with good anatomical alignment within an average of 9.2 weeks. The most common fracture pattern seen in

children was a transverse pattern. Clinically all patients had good range of motion in hip and knee joints at the last follow up. Patients had been

actively involved in sport activities with no restriction. The average follow up was 17.8 months (range 12–24 months).

Conclusion: Semitubular plate expands the option available for challenging fixation in paediatric subtrochanteric fractures. It is safe, cheap

and easily reproducible technique in treating subtrochanteric femoral fractures in children within age group of 3–6 years.