MANAGEMENT OF PAEDIATRIC SUBTROCHANTERIC FRACTURE WITH PAEDIATRIC DYNAMIC HIP SCREW-A CASE REPORT

Hip fractures in children are relatively rare and account for less than 1 of all paediatric fractures. Subtrochanteric fractures in children are very rare and are reported very few in world literatures. A ten year old girl presented with history of fall from compound wall and had pain, swelling over right hip and difficulty in using right lower limb. X-ray pelvis with both hips anteroposterior view was taken which showed displaced subtrochanteric fracture of the right femur. Patient was planned for internal fixation with paediatric dynamic hip screw. Intra operative and post operative period was uneventful. After 6 weeks patient was advised weight bearing as tolerated. At the end of 12 months the functional outcome was good. Range of movements were functionally normal. Among the multiple treatment options available paediatric dynamic hip screw has a good functional outcome. Patients treated with paediatric dynamic hip screw require less assistance, can walk with crutches within ten days postoperatively and return to school. Frequent follow-up clinically and radiographically is needed if mal-union or leg length discrepancy is present. A prospective randomized multicentric study is needed to support paediatric hip screw as the standard operative treatment.