Submuscular nonlocking plates: an effective option for pediatric extra-articular proximal femur fractures

The aim of this study is to evaluate the results of submuscular plating using nonlocking plates for extra-articular proximal femur fractures (EPFF) in children. From our hospital records, we retrieved data of 15 children treated with submuscular plating with nonlocking dynamic compression plates (DCP) for EPFF between January 2010 and September 2021. EPFF was defined as a proximal femur fracture within 10% of the femoral length below the lesser trochanter. Patients' demographics, as well as details of the duration of operation, type of DCP used, time to union, complications, and outcomes using Flynn criteria were noted. There were nine males and six females. Mean age of the patients was 10.8 ± 1.9 years (range 7-14 years). All the patients had fracture union and two patients had union with an angulation less than 10°. All fractures healed uneventfully with a mean time to union of 11.8 ± 1.2 weeks (range 10-15 weeks). No patient required surgery for complications or malunion. Using Flynn criteria, excellent outcomes were seen in 13 out of 15 patients. There were no poor outcomes. Our study shows that submuscular plating using nonlocking plates is an effective option for treating pediatric EPFF. Treatment of these tricky fractures with submuscular plating using nonlocking plates shows excellent outcomes with minimal complications.