Surgical Treatment of the Proximal Femoral Fractures in Pediatrics / 대한정형외과학회잡지

ABSTRACT

PURPOSE: The proximal femoral fractures in children are rare but the complications are grave. The importance of this fracture is related to the frequency of complications. So authors evaluated the result of early surgical treatment of proximal femoral fracture. MATERIALS AND METHODS: From February 1993 to June 1997, authors have treated 8 cases of displaced proximal femoral fractures in children follow up, more than a year. We classified fracture type by Delbet's, and functional results by Ratcliff's. Internal fixation was done with smooth steinmann pins or small caliber cannulated screws. RESULTS: According to the Delbet's classification, the cases of type II, III, IV were 2, 5, 1. The average age was 7.3 years and boys were predominant (7 cases). Seven cases were treated by immediate anatomical reduction and internal fixation and one was delayed. The mean operation time was 52.7 minutes, duration of hip spica cast was 5.8 weeks and the time of union was 10.9 weeks in average. The mean time to partial weight bearing and full weight bearing were 10.3 and 13.9 weeks. The fixation devices were removed at 24.3 weeks in average. All cases were excellent. CONCLUSION: We suggest that immediate anatomical reduction and internal fixation is the one of the best way to reduce the frequency and severity of the complication of proximal femoral fractures and can expect good functional results in children.