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We report the results of treatment in 99 children with subtrochanteric fractures of the femur. Late reviews of 60 of the 65 children treated with traction and then a hip spica after stabilization of the fracture by callus, and of 20 of the 22 treated with early closed reduction and a hip spica yielded 80% satisfactory outcomes. However, 27% of the fractures treated with early closed reduction required remanipulation. The satisfactory outcomes in the traction and delayed spica group would be increased to nearly 100% by using only skin traction, as persistent lengthening of the femur and pin-site pain, the main long-term complications, were the result of skeletal traction. Late review of 10 of the 12 children treated surgically showed 100% satisfactory medical outcomes but only 60% satisfactory patient-determined outcomes. Persistent pain in the thigh incision used for open reduction was the main cause of patient dissatisfaction.

Original publication

DOI

10.1097/00004694-199801000-00005

Type

Journal article

Journal

Journal of pediatric orthopedics

Publication Date

01/1998

Volume

18

Pages

22 - 25

Addresses

Division of Orthopaedics, Hospital for Sick Children, Toronto, Ontario, Canada.

Keywords

Humans, Hip Fractures, Treatment Outcome, Traction, Bandages, Child, Patient Satisfaction, Female, Male