Management of Long, Comminuted Pediatric Subtrochanteric Fractures Using PHILOS (Proximal Humeral Internal Locked System): A Case Series

Abstract

Subtrochanteric fractures in the pediatric population are rare, and there are currently no existing management guidelines. In this innately unstable fracture type, intramedullary devices preferred for adults cannot be used in children with open growth plates. A PHILOS locking plate is meant to be used in the management of proximal humerus fractures in adults, and its secondary use in children has been sparsely described in the literature.Four pediatric patients (age range 8-14 years) with comminuted subtrochanteric femur fractures with a length averaging 7 cm (range 3.5-9.5 cm) were managed via open reduction and internal fixation using PHILOS (Proximal Humeral Internal Locked System) plates by the same surgeon and were followed up for six months, all resulting in excellent outcomes.The PHILOS plate is a viable option in the management of subtrochanteric femur fractures in the pediatric population and long complex fracture patterns without violating the greater trochanteric physis.