Paediatric Subtrochanteric Femur Fracture Treated with PHILOS Plate: A Case Report

Chew, Jun Jie; Phang, Zi Hao; OOI, Boon Hong; Ibrahim, Saadon

doi:10.37515/ortho.8231.1101

Cited by 3 publications

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“…To the best of our knowledge, Gogna et al reported the largest series including 8 pediatric subtrochanteric femur fractures treated with adult proximal humerus plate and showed favorable outcomes 13. Chew et al used the adult proximal humerus plate for the treatment of a subtrochanteric femur fracture in a 13-year-old female patient and reported a satisfactory outcome 14. Newbury et al reported the only case in the literature showing the utility of the adult proximal humerus plate in a pathological subtrochanteric femur fracture of a 14-year-old boy due to aneurysmal bone cyst and achieved successful repair of the fracture 15.…”

Section: Discussionmentioning

confidence: 99%

“…13 Chew et al used the adult proximal humerus plate for the treatment of a subtrochanteric femur fracture in a 13-year-old female patient and reported a satisfactory outcome. 14 Newbury et al reported the only case in the literature showing the utility of the adult proximal humerus plate in a pathological subtrochanteric femur fracture of a 14-year-old boy due to aneurysmal bone cyst and achieved successful repair of the fracture. 15 In our series, all fractures united well with a mean time to union of 8.2 weeks, including pathological fractures.…”

Section: Discussionmentioning

confidence: 99%

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An Alternative Fixation Option for Subtrochanteric Femur Fractures in Children: Adult Proximal Humerus Plate

Danışman

Özdemir

Dursun

et al. 2022

Journal of Pediatric Orthopaedics

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Background: Subtrochanteric femur fractures are unstable injuries due to strong muscle forces on the proximal femur. The ideal fixation device is controversial in the treatment of subtrochanteric femur fractures in children. The aim of this study is to evaluate the clinical and radiological outcomes of subtrochanteric femur fractures in children treated with an adult proximal humerus plate. Methods: A total of 9 patients [mean age at surgery, 8.3 years (range: 7 to 12); mean follow-up period, 28.1 months (range: 12 to 56)] who underwent surgery due to a subtrochanteric femur fracture and treated with an adult proximal humerus between January 2017 and December 2021 were retrospectively evaluated. Four of the patients had a pathological fracture associated with a benign bone tumor while 5 patients had a nonpathological fracture. The clinical and radiological outcomes were assessed using the Flynn scoring system at the latest follow-up. Time to union and complications were recorded. Results: All patients demonstrated a solid fusion of the fracture site and were able to bear full weight at the latest follow-up. The mean time to union was 8.2 weeks (range: 6 to 10). Based on the Flynn scoring system at the latest follow-up, seven patients had excellent clinical outcomes and two patients had satisfactory outcomes. Two patients had limb length discrepancy, and one patient had coxa valga and a limb length discrepancy of 16 mm. There were no patients with nonunion, infection, implant failure, osteonecrosis of the femoral head, and heterotopic bone formation. Conclusion:This study suggests that the adult proximal humerus plate may be an effective alternative fixation option in the treatment of subtrochanteric femur fractures in children, including pathological fractures.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

An Alternative Fixation Option for Subtrochanteric Femur Fractures in Children: Adult Proximal Humerus Plate

Danışman

Özdemir

Dursun

et al. 2022

Journal of Pediatric Orthopaedics

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“…3 Chew et al also described the use of a PHILOS plate in managing a subtrochanteric femur fracture in a 13-year-old patient with excellent results, followed over six months. 4…”

Section: Introductionmentioning

confidence: 99%

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

Morales,

Illescas,

Aguilar

et al. 2024

PJO

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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.

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Extended Use of Proximal Humeral Locking Plates in Pediatric Femur Fractures and Osteotomies

Singh,

Agrawal,

Jain

et al. 2024

Techniques in Orthopaedics

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Objective: To assess the extended use of proximal humeral locking plates in paediatric femur fractures and osteotomies. Background: Pediatric fractures and deformity correction pose unique challenges in orthopedic surgery. The utilization of the proximal humerus locking plates (PHLPs) in the pediatric population remains a relatively unexplored area. This manuscript presents a case-based analysis of the extended use of PHLP in pediatric femur fractures and osteotomies. Four distinct cases involving the use of PHLP are discussed, demonstrating its versatility and efficacy in addressing a variety of orthopedic conditions in the pediatric age group. Methods: We retrospectively reviewed the medical records of 4 pediatric patients who underwent surgical interventions utilizing PHLP at our institution. Case 1 involved a 9-year-old girl with a neglected neck of femur fracture, managed with in situ screw fixation and valgus osteotomy and stabilization using a PHLP. Case 2 featured a 10-year-old boy with a distal femur fracture, managed with a PHLP. Case 3 highlighted a 12-year-old girl with genu valgum, who underwent medial closing wedge osteotomy stabilized with a PHLP. Lastly, case 4 presented an 11-year-old boy with a subtrochanteric femur fracture, also managed using a PHLP. Surgical techniques, postoperative care, and outcomes were analyzed. Results: All 4 cases maintained satisfactory stability and alignment at final follow-up. All of them returned to preinjury status within 6 months. Conclusion: The extended use of proximal humeral locking plates in pediatric femur fractures and osteotomies presents a viable option for orthopedic surgeons. These cases illustrate the versatility and positive outcomes associated with PHLP in the pediatric population.

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Paediatric Subtrochanteric Femur Fracture Treated with PHILOS Plate: A Case Report

Cited by 3 publications

References 0 publications

An Alternative Fixation Option for Subtrochanteric Femur Fractures in Children: Adult Proximal Humerus Plate

An Alternative Fixation Option for Subtrochanteric Femur Fractures in Children: Adult Proximal Humerus Plate

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

Extended Use of Proximal Humeral Locking Plates in Pediatric Femur Fractures and Osteotomies

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