The management of pediatric subtrochanteric femur fractures with a statically locked intramedullary nail.
OBJECTIVE
To evaluate locked intramedullary (IM) fixation as an alternative treatment method for children with subtrochanteric fractures.


METHODS
Retrospective review.


METHODS
Level 1 trauma center in a Children's Hospital.


METHODS
Pediatric patients with subtrochanteric femur fractures with open growth plates.


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


METHODS
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.


METHODS
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
*Center for Orthopedics at the Arnold Palmer Hospital for Children, Orlando, FL; †Orthopedic Residency Program, Orlando Regional Medical Center, Orlando, FL; and ‡Department of Orthopedics, Alpena Regional Medical Center, Alpena, MI.
José A
JA
Herrera-Soto
Robert
R
Meuret
Jonathan H
JH
Phillips
Daniel J
DJ
Vogel
D000293:Adolescent; D001858:Bone Nails; D002648:Child; D005260:Female; D005594:Fracture Fixation, Intramedullary; D006132:Growth Plate; D006620:Hip Fractures / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D012189:Retrospective Studies