Key result
Treatment of pediatric subtrochanteric fractures with 90°-90° traction and casting resulted in a mean overgrowth of 10 mm and minimal differences in anteversion (2°) and neck shaft angle (1°).
Why the study?
Does 90°-90° traction followed by cast application result in acceptable alignment in children under 10 with subtrochanteric femoral fractures?
Observational (n=15)
Does 90°-90° traction followed by cast application result in acceptable alignment in children under 10 with subtrochanteric femoral fractures?
Treatment of subtrochanteric femoral fractures in children under 10 with 90°-90° traction and casting results in excellent long-term alignment and remodeling.
May support nonoperative care in select cases under 10; leaves open prospective validation of remodeling.
Fifteen children younger than 10 years of age with subtrochanteric fractures treated by a uniform method were evaluated. These patients had been treated with femoral skeletal traction, with the hip and knee flexed to 90° until radiographic callus appeared, then with a hip spica cast. True neck to shaft and anteversion angles were calculated bilaterally using a biplanar method. Leg lengths were measured radiographically and clinically. Mean age at injury was 4.5 years, and mean followup was 6.5 years. Overgrowth averaged 10 mm after fracture. Anteversion at final followup differed only by a mean of 2° from the contralateral side (range, −3°-+4°), and the mean neck shaft angle differed by only 1°. Remodeling of coronal angulation was 50% or more in all cases.
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Jeng et al. (1997) conducted an observational in Subtrochanteric fractures (n=15). 90°-90° femoral skeletal traction and hip spica cast vs. Contralateral side was evaluated on Anteversion, neck shaft angle differences, and leg length overgrowth. Treatment of pediatric subtrochanteric fractures with 90°-90° traction and casting resulted in a mean overgrowth of 10 mm and minimal differences in anteversion (2°) and neck shaft angle (1°).
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