title: Management of subtrochanteric fractures of the femur in children.
abstract: We report the results of treatment in 99 children with subtrochanteric fractures of the femur. Late reviews of 60 of the 65 children treated with traction and then a hip spica after stabilization of the fracture by callus, and of 20 of the 22 treated with early closed reduction and a hip spica yielded 80% satisfactory outcomes. However, 27% of the fractures treated with early closed reduction required remanipulation. The satisfactory outcomes in the traction and delayed spica group would be increased to nearly 100% by using only skin traction, as persistent lengthening of the femur and pin-site pain, the main long-term complications, were the result of skeletal traction. Late review of 10 of the 12 children treated surgically showed 100% satisfactory medical outcomes but only 60% satisfactory patient-determined outcomes. Persistent pain in the thigh incision used for open reduction was the main cause of patient dissatisfaction.
authors.affiliation: Division of Orthopaedics, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: T N
authors.initials: TN
authors.lastname: Theologis
authors.forename: W G
authors.initials: WG
authors.lastname: Cole
mesh_terms: D001458:Bandages; D002648:Child; D005260:Female; D006620:Hip Fractures / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D014143:Traction; D016896:Treatment Outcome