Management of subtrochanteric fractures in skeletally immature adolescents.
BACKGROUND
There have been no studies that have specifically looked at the management of subtrochanteric femoral fractures in skeletally immature adolescents. It was the purpose of this study to investigate the treatment of this injury in this unique patient population.


METHODS
A retrospective review of all subtrochanteric femoral fractures treated at a major pediatric trauma center since 1990 was performed.


RESULTS
There were 13 adolescents with an average age of 13 years and 6 months. The average length of follow-up was 2 years and 3 months. Eight of the 10 operatively treated patients had a satisfactory result, whereas the outcome was unsatisfactory in all three patients treated nonoperatively. Complications included three limb-length discrepancies, one case of avascular necrosis of the femoral head, one transient peroneal nerve palsy, and one case of asymptomatic heterotopic ossification. At the time of most recent follow up, all had returned to preinjury level of function.


CONCLUSIONS
Operative treatment provided more satisfactory results than nonoperative methods.
Jarvis
James
J
Division of Orthopaedics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada.
Davidson
Darin
D
Letts
Merv
M
D000293:Adolescent; D001858:Bone Nails; D001860:Bone Plates; D002648:Child; D005260:Female; D005271:Femur Head Necrosis / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D005594:Fracture Fixation, Intramedullary; D017102:Fracture Healing; D006132:Growth Plate / Q000000981:diagnostic imaging / Q000601:surgery; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007870:Leg Length Inequality / Q000000981:diagnostic imaging; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011859:Radiography; D012189:Retrospective Studies; D000072042:Salter-Harris Fractures; D014143:Traction