Key result
Management of pediatric subtrochanteric femoral fractures with a broad dynamic compression plate and proximal cancellous screw yielded excellent functional outcomes in 84.38% of patients.
Why the study?
Pediatric subtrochanteric femoral fractures can be managed with multiple modalities, and prognosis depends on adequate reduction and stable fixation, but functional outcomes with broad dynamic compression plate required evaluation.
Does a broad dynamic compression plate with a proximal cancellous screw improve functional outcomes in pediatric patients with subtrochanteric femoral fractures?
Observational (n=32)
No
Does a broad dynamic compression plate with a proximal cancellous screw improve functional outcomes in pediatric patients with subtrochanteric femoral fractures?
Treatment of pediatric subtrochanteric femoral fractures with a broad dynamic compression plate and proximal cancellous screw yields excellent or satisfactory functional outcomes with a 100% union rate.
May support broad DCP with proximal screw for good outcomes in select cases; leaves open need for comparative trials.
Introduction: Pediatric subtrochanteric femoral fracture can be managed with traction followed by spica, intramedullary elastic nailing, plating or external fixators. The prognosis largely depends on adequate reduction and stable fixation. Aims:The aim of this study was to evaluate functional outcome of pediatric subtrochanteric femoral fracture treated with broad dynamic compression plate. Methods: This prospective observational study consisted of 32 children between the age 7 to 15 years, with an average of 10.06 years ± 2.29, with subtrochanteric femoral fracture. Fractures were reduced by an open reduction through lateral approach and stabilized with a broad dynamic compression plate along with a proximal cancellous screw through the femoral neck. All patients were followed for 15 months and the results were evaluated on the basis of Flynn scoring system. Results: All fractures united with a mean duration of 12.6 weeks ± 0.91. Average hospital stay was 8.43 days (5 to 14 days). Functional outcome was excellent in 84.38% (27 patients) and satisfactory in 15.62% (5 patients). Full weight bearing was started after mean duration of 16.62 weeks ± 0.91. Implants were removed at an average of 11.21 months ± 1.06. There were no significant limb length discrepancies, deep infections, re-fracture, osteomyelitis and avascular necrosis. Conclusion: This prospective study showed good functional outcome in pediatric patients having subtrochanteric femoral fractures who were treated with a broad dynamic compression plate and a proximal cancellous screw through neck.
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Karki et al. (2021) conducted an observational in Pediatric subtrochanteric femoral fracture (n=32). Broad dynamic compression plate and proximal cancellous screw through the femoral neck was evaluated on Excellent functional outcome (Flynn scoring system). Management of pediatric subtrochanteric femoral fractures with a broad dynamic compression plate and proximal cancellous screw yielded excellent functional outcomes in 84.38% of patients.
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