Management of Subtrochanteric Fractures in Skeletally Immature Adolescents

Jarvis, James; Davidson, Darin; Letts, Merv

doi:10.1097/01.ta.0000197606.63124.9e

Cited by 26 publications

(20 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite the very small sample size, the authors concluded that internal fixation was more effective than non-operative treatment. [22] With the wide range of fixation options that are currently available for treatment of femur fractures in schoolage children and skeletally immature adolescents and the low risk of associated complications, we recommend against nonoperative management of subtrochanteric femur fractures in this age group. Pombo and Shilt examined 13 pediatric patients with subtrochanteric femur fractures treated with titanium elastic nails.…”

Section: Discussionmentioning

confidence: 99%

Outcome of titanium elastic nailing in pediatric subtrochanteric femur fractures: A case series

Barua¹,

Bansal²,

Harikrishnan³

2019

Int. J. Orthop. Sci.

View full text Add to dashboard Cite

Introduction: Subtrochanteric femur fractures are difficult injuries to treat in children. Although elastic stable intramedullary nails are commonly used for pediatric femur shaft fractures, there is little information on their effectiveness for managing pediatric subtrochanteric femur fractures. We are not aware of any published study that defines outcome of titanium elastic nail in treatment of pediatric subtrochanteric femur fractures. We, in this study, evaluated radiographic union rates, fracture alignment, and complications after titanium elastic nailing of pediatric subtrochanteric femur fractures. Materials and Methods: A total of 10 cases of pediatric subtrochanteric femur fractures were admitted in our department between November 2016 and April 2018. This prospective study included 8 males and 2 females, with a mean age of 7.9 years (5-11 years). All patients were treated with elastic stable intramedullary nails and had complete follow up until clinical and radiographic union. Results: All patients had clinical healing with full weight-bearing and the functional outcome scores were satisfactory. No cases of infection were reported at the time of the last follow-up visit. Complications included malunion (n = 1), irritation (n = 1) at nail insertion site, and limb length discrepancy (n = 1). Despite these complications, there were 7 (70%) excellent, 3 (30%) satisfactory, and none with poor outcomes. Conclusions: Titanium elastic nailing is an important option for treating subtrochanteric femur fractures in children with low complication rates.

show abstract

Section: Discussionmentioning

confidence: 99%

Outcome of titanium elastic nailing in pediatric subtrochanteric femur fractures: A case series

Barua¹,

Bansal²,

Harikrishnan³

2019

Int. J. Orthop. Sci.

View full text Add to dashboard Cite

show abstract

“…22 With the wide range of fixation options that are currently available for treatment of femur fractures in school-age children and skeletally immature adolescents, and the low risk of associated complications, we recommend against nonoperative management of subtrochanteric femur fractures in this age group. Jarvis and colleagues retrospectively reviewed 13 skeletally immature adolescents who had undergone treatment of a subtrochanteric femur fracture with a variety of different techniques.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Titanium Elastic Nail and Plate Fixation of Pediatric Subtrochanteric Femur Fractures

Liu

Heyworth

Glotzbecker

et al. 2013

Journal of Pediatric Orthopaedics

View full text Add to dashboard Cite

show abstract

“…It is challenging to obtain and maintain the reduction of the proximal fracture fragment due to the flexion, abduction, and external rotation secondary to forces from the iliopsoas, hip abductors, and external rotator muscles in the subtrochanteric region of the femur. [ 6 ] Jarvis et al [ 4 ] retrospectively reported that about one-fourth skeletally immature adolescents with subtrochanteric fracture had poor clinical and radiologic outcomes by nonoperative management, including fracture malalignment with more than 16° of angulation, and lower limb length shortening of the affected limb by an average of 2.6 cm. Therefore, surgical intervention with internal fixation became more popular.…”

Section: Discussionmentioning

confidence: 99%

“…[ 1 – 3 ] Rigid intramedullary nailing and locking compression plating are the preferred treatment in adolescents. [ 4 , 5 ] Few studies focused on the treatment of the school-aged children or young adolescents between 5 and 12 years of age suffering from subtrochanteric femur fracture. [ 6 ] The optimal choice of internal fixation for these patients is discussed controversially.…”

Section: Introductionmentioning

confidence: 99%

Titanium elastic nailing versus locking compression plating in school-aged pediatric subtrochanteric femur fractures

Bian²,

Shen³

et al. 2018

Medicine

View full text Add to dashboard Cite

The treatment of children between 5 and 12 years of age suffering from subtrochanteric femoral fracture is challenging. The optimal choice of internal fixation for these patients is controversial. The purpose of this study is to compare the outcomes and complications of titanium elastic nail and open reduction with plate fixation of subtrochanteric femur fractures in school-aged children.A total of 67 children aged 5 to 12 years with subtrochanteric femur fractures treated with titanium elastic nails or open plating were identified at our institution from January 2007 to December 2017. We retrospectively compared 39 children treated with titanium elastic nails with 28 children treated with open reduction and plate fixation. The data included age, sex, body weight, fracture pattern, operation time, blood loss, and length of hospitalization. The follow-up investigations included radiograph of pelvis, bilateral hip range of motion, bilateral femoral neck shaft angle, and length of lower extremity. The outcomes were classified according to Flynn classification as excellent, satisfactory, or poor. All the demographic characteristics were compared with statistical analyses.All 67 fractures united properly. No major postoperative complications were noted in both groups. No significant difference was found between the titanium elastic nail and open plating groups in terms of sex, fracture pattern, and length of hospitalization. We noted a significant difference between 2 groups in terms of age, weight, operation time, and blood loss. In total, we observed 24 excellent and 15 satisfactory results in the titanium elastic nail group, and 19 excellent results and 9 satisfactory results in the open plating group. There was no significant statistical difference between involved and uninvolved side of hip regarding range of motion and femoral neck shaft angle in both groups.Titanium elastic nail and pediatric hip plate fixation represent safe and effective methods in the treatment of subtrochanteric fractures in school-aged children. Titanium elastic nail internal fixation is a minimal invasive and simpler technique and suitable for young children of lower body weight. Open plate fixation is a more rigid fixation associated with a lower complication rate.

show abstract

Management of Subtrochanteric Fractures in Skeletally Immature Adolescents

Abstract: Operative treatment provided more satisfactory results than nonoperative methods.

Cited by 26 publications

References 28 publications

Outcome of titanium elastic nailing in pediatric subtrochanteric femur fractures: A case series

Outcome of titanium elastic nailing in pediatric subtrochanteric femur fractures: A case series

Comparison of Titanium Elastic Nail and Plate Fixation of Pediatric Subtrochanteric Femur Fractures

Titanium elastic nailing versus locking compression plating in school-aged pediatric subtrochanteric femur fractures

Contact Info

Product

Resources

About