Adult proximal humerus locking plate for fixation of paediatric intertrochanteric femoral fractures

Abstract

Aims: There are multiple fixation methods for the surgical treatment of intertrochanteric femur fractures in children and adolescents, but there is still no consensus on the optimal implant. Recently, adult proximal humeral locking plates have been advocated for the fixation of these fractures; however, insufficient data is available for their efficacy. This retrospective study evaluated the radiological and clinical outcomes of pediatric intertrochanteric fractures treated with adult humerus proximal plates. Methods: This was a single-center, retrospective study that included children aged between 11 and 16 years who underwent surgery for intertrochanteric hip fractures using adult proximal humeral locking plates between January 2012 and January 2019. The exclusion criteria were nondisplaced fractures, concomitant musculoskeletal and other system injuries, pathological fractures, and a history of previous surgery on the same hip or femur. The duration of fracture union was evaluated in the follow-up radiographs. Clinical outcomes were evaluated using the Harris hip score (HHS) and Ratliff criteria. All complications during the follow-up were recorded. Results: The study included 24 children (15 males, nine females) with a mean age of 12.6±1.4 years (11 to 15 years). The mean follow-up time was 34±9.4 months (22 to 60 months). The mean fracture union time was 12.8±2.2 weeks (10 to 16 weeks). The HHS was 92±1.9 (89 to 95) at the final follow-up. All patients were rated good according to the Ratliff criteria. None of the patients had avascular necrosis of the femoral head, nonunion, malunion, limb-length discrepancy, or implant failure at the final follow-up. No patient required revision surgery. Conclusions: The findings of this study showed that the fixation of pediatric intertrochanteric fractures with adult humerus proximal plates is a successful fixation option that provides good clinical outcomes based on the HHS and Ratliff criteria, and excellent radiological outcome with a high rate of fracture union, with low complication rates. ABSTRACT