![]() As per- et subtrochanteric are not adequately represented, Arbeitsgemeinschaft Osteosynthese (AO) classification according to Müller et al. Accordingly, pertrochanteric fractures are classified as Delbet type IV (Fig. Hip fractures of the growing skeleton are classified after Delbet and Colonna (type I–IV). We analyzed the data of 20 patients with trochanteric fractures (12 males 8 females mean age, 12 years range, 4–17 years). Prior to this investigation, the corresponding institutional Review Board approved this study. All patient information, disease, and treatment-related data were retrieved by a review of the patients’ charts. We identified 20 patients between 19 with trochanteric fractures under the age of 18 who were treated at our department.ĭiagnosis was based on recognized radiological and clinical criteria. ![]() Furthermore, it was the goal to increase awareness of the different methods of fixation available for these fractures in children and adolescents. This study is dealing with the surgical treatment of these rare fractures of the trochanteric region in children and adolescents and is the most comprehensive case series in recent literature. Predisposing factors for poor outcome or fracture complications, such as non-union or femoral head necrosis, are described in literature. In literature, most information regarding these fractures is found in collectives of pediatric hip fractures with the focus set on femoral neck fractures. Though, complications such as coxa vara deformity, leg length differences, and non-union are described. As fractures of the trochanteric region are not affecting the epiphysis, femoral head necrosis or relevant growth disturbance is not expected. In toddlers and non-displaced fractures, a conservative approach (e.g., casting to rest and traction) is a therapeutic option. delayed) seems a crucial factor for outcome. Transepiphyseal, transcervical, and displaced cervicotrochanteric fractures, however, generally require closed/open reduction and internal fixation to avoid complications. ĭue to the rareness of these fractures, no evidence-based management is known. If there is a fracture caused by an inadequate trauma (e.g., simple fall, movement), the underlying disease (pathologies in bone metabolism, preexisting bone deformation, various benign/malignant bone tumors) has to be identified and treated. Generally, there are only two mechanisms to cause a fracture of the proximal femur in children: high-energy trauma or in case of inadequate trauma, predisposing bone pathologies. Excellent long-term results can be achieved with an adequate fracture reduction.Ĭonclusion: Physicians treating pediatric trauma have to be aware of other predisponding diseases when low-energy trauma leads to a trochanteric fracture as in this study, 50% of the trochanteric fractures were associated with bone pathologies.įemoral fractures of the trochanteric region in the pediatric population are very rare accounting for less than 1% of all fractures in children. Trochanteric femoral fractures in children and adolescents are very rare accounting for only 1% of all trochanteric fractures. Eighty-five percent of the patients reached an excellent clinical outcome after treatment. Harris Hip Score was evaluated in all patients with a mean score of 94.16 (range 11 to 100). Complications occurred after a mean time of 6.27 months (range, 0.47 to 12.07 months) in two patients. All 20 patients were treated operatively. The mean follow-up of all patients was 50.06 months. We identified 20 patients between 19 with a trochanteric fracture under the age of 18 (12 males 8 females mean age, 12 years range, 4–17 years) who were treated operatively at our department. For femoral fractures of the trochanteric region in children and adolescents, only two mechanisms have been identified to cause a fracture of the proximal femur: high-energy trauma or predisposing bone pathologies with inadequate trauma (e.g., simple fall, movement).
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