Transtrochanteric Transverse Fracture of Proximal Femur in Pediatric Child: A Rare Variant: Case Report and Surgical Management.

Introduction: Femoral fractures in the transtrochanteric region and avulsion of the greater trochanter in skeletally immature individuals occur due to high-energy trauma. Due to the unique anatomy and blood supply of the proximal femur in growing children, these fractures are notorious for high rates of complications despite appropriate management. Classification of these fractures is done according to the Delbet system and AO classification, which not only guides management but also provide prognostic clues. Multiple fixation methods have been described, and there is no consensus on what constitutes the best treatment. Non-union, coxa vara, and pre-mature physeal arrest are the most frequent complications. The association of a transverse transtrochanteric proximal femur fracture with avulsion of the greater trochanter in a young patient, to the best of our knowledge, has not been previously described in the literature.

Case report: We present the case of a 16-year-old boy who sustained an injury to the right hip following a high-velocity road traffic accident. Initial clinical examination revealed severe swelling and tenderness in the hip joint, and imaging confirmed a transtrochanteric transverse fracture with a greater trochanter avulsion fracture. Higher imaging, such as computed tomography, was performed to understand the fracture anatomy. Surgical management involved open reduction and internal fixation of the proximal femur. Post-operative rehabilitation focused on joint mobility and strength, and the patient achieved full weight-bearing and near-complete range of motion by 3 months.

Conclusion: A transtrochanteric transverse fracture with greater trochanter avulsion requires appropriate surgical intervention, which helps in early mobilization and prevents long-term complications.