Internal fixation of subtrochanteric femoral fractures in children using a T-plate

Abstract

BackgroundDisplaced subtrochanteric femoral fractures in children can be difficult to treat because of inherent fracture instability, a short metaphyseal fragment, and close proximity of the fracture to the growth plate. Different treatment options are used: traction, spica casting, internal fixation, and external fixation.ObjectiveThe aim of this study was to present our results with internal fixation of subtrochanteric femoral fractures in children using a 3.5-mm T-plate.Patients and methodsBetween January 2012 and July 2014, 10 patients with closed displaced subtrochanteric femoral fractures were treated in Al-Azhar University Hospitals. The average age at the time of injury was 7.2 years (range: 5.5-9.3 years). Open fractures, pathological fractures, and fractures associated with neuromuscular diseases were excluded from this study. Three patients had multiple injuries and seven (70%) patients had isolated subtrochanteric femoral fractures. In all cases a single 3.5-mm T-plate was used, and two or three 4-mm cancellous screws were inserted through the plate into the femoral neck. Average follow-up was 12 months (range: 9-18 months).ResultsAll fractures united with anatomical alignment within an average of 8 weeks (range: 6-12 weeks). There were no complications. At the latest follow-up, no patient had any restriction of activities.ConclusionInternal fixation with a T-plate appears to be a good treatment option for children with subtrochanteric femoral fractures.