Proximal Femur Fractures in Children: Enigmatic Injuries

Instructional Course Lectures
|February 8, 2020
PubMed

Insights

Managing proximal femur fractures in children is complex, involving various fracture types and potential complications like avascular necrosis. Improved understanding of classification, outcomes, and 2018 management strategies aids pediatric orthopedic surgeons.

Area of Science:

  • Orthopedic Surgery
  • Pediatric Orthopedics
  • Pediatric Traumatology

Background:

  • Proximal femoral fractures in skeletally immature patients present significant management challenges.
  • These injuries encompass femoral head/neck, intertrochanteric, and subtrochanteric fractures.
  • The Delbet classification system traditionally covers pediatric proximal femur injuries, excluding subtrochanteric fractures.

Purpose of the Study:

  • To review the history, classification, and complications of proximal femoral fractures in pediatric patients.
  • To discuss factors influencing outcomes and current management strategies.
  • To enhance preoperative and intraoperative decision-making for orthopedic surgeons.

Main Methods:

  • Literature review focusing on pediatric proximal femur fractures.
  • Analysis of historical and current classification systems.
  • Examination of potential complications and outcome determinants.

Main Results:

  • Complications include coxa vara, osteonecrosis, premature physeal closure, and nonunion.
  • Many risk factors for poor outcomes are not modifiable.
  • Familiarity with updated knowledge is crucial for better patient results.

Conclusions:

  • Effective management requires a thorough understanding of fracture types, classification, and potential complications.
  • While some risk factors are immutable, informed surgical decisions can improve outcomes.
  • Knowledge of 2018 management options is vital for optimizing pediatric proximal femur fracture treatment.