The management of pediatric subtrochanteric femur fractures with a statically locked intramedullary nail.

OBJECTIVES

To evaluate locked intramedullary (IM) fixation as an alternative treatment method for children with subtrochanteric fractures.

DESIGN

Retrospective review.

SETTING

Level 1 trauma center in a Children's Hospital.

PATIENTS/

PARTICIPANTS

Pediatric patients with subtrochanteric femur fractures with open growth plates.

INTERVENTION: All patients were treated with a lateral entry IM locking nail.

OUTCOME MEASUREMENTS: Patients were followed until full fracture consolidation or until implant removal. Data on time to full weight bearing, return to full activity, residual pain, any form of gait abnormality, and any other complication from follow-up visits were collected.

RESULTS

There were 9 males and 1 female patient with an average age of 12 years and average follow-up of 22 months. Most of the fractures occurred secondary to high-energy trauma. Partial weight bearing was started at 24 days and full at 66 days. Implants were removed on average at 11 months after implantation. There were neither intraoperative complications nor major complications in the postoperative period recorded after removal. Two patients presented with a longer limb on the affected side, both 8 mm, and 2 presented with asymptomatic grade I heterotopic ossification.

CONCLUSIONS

The use of a statically locked lateral entry IM nail for subtrochanteric femur fractures in children is a safe and efficacious method of treatment with few complications and risks and satisfactory outcomes in children over the age of 8 years.

LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.