Early Failure of Locking Compression Plates in Pediatric Proximal Femoral Fracture Original Research

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Seth R. Cope
Matthew Wideman
Benjamin W. Sheffer
Jeffrey R. Sawyer
James H. Beaty
William C. Warner Jr.
David D. Spence
Derek M. Kelly

Abstract

Background: Although proximal femoral locking compression plates (PF-LCP) have been used with increasing frequency in the fixation of proximal femoral fractures in the pediatric population, there is a lack of literature regarding their use. The purpose of this study was to examine the failure rates of PF-LCP fixation in comparison to other accepted fixation methods within a pediatric population.


Methods: Retrospective review identified consecutive children treated for proximal femoral fractures from September, 2008 to February, 2019, who had a minimum follow-up of 12 weeks. Patient charts and radiographs were reviewed, and demographic information was compiled. In the case of failures, timing and method of failure were documented.


Results: Sixty-four proximal femoral fractures (61 children) were studied. The average age at the time of presentation was 10.4 years. Twenty-six fractures were treated with PF-LCPs and 38 with other fixation methods (compression hip screws, rigid locked intramedullary nailing, cannulated screws, or a combination of hip screw side plate and intramedullary nailing). Failure occurred in four of the 26 fractures treated with locking compression plating (15.4%), compared to none of the 38 treated with other fixation types (p<0.05).


Conclusions: This study demonstrates an increased risk of failure in proximal femoral fractures treated with locking compression plates (12.9%) compared to 0% other fixation methods (no failures). As a result of this study, we no longer use locked plating systems for pediatric femoral neck fractures at our institution.

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How to Cite
Cope, S. R., Wideman, M., Sheffer, B. W., Sawyer, J. R., Beaty, J. H., Warner Jr., W. C., Spence, D. D., & Kelly, D. M. (2023). Early Failure of Locking Compression Plates in Pediatric Proximal Femoral Fracture: Original Research. Journal of the Pediatric Orthopaedic Society of North America, 5(3). https://doi.org/10.55275/JPOSNA-2023-436
Section
Trauma
Author Biographies

Seth R. Cope

Orthopaedic Resident

University of Tennessee Health Science Center, College of Medicine, Memphis, TN

Matthew Wideman

Medical Student, University of Tennessee Health Science Center, College of Medicine

Benjamin W. Sheffer

Orthopaedic Surgeon, University of Tennessee-Campbell Clinic Department of Orthopaedic Surgery & Biomedical Engineering, Memphis, TN

LeBonheur Children's Hospital, Memphis, TN

Jeffrey R. Sawyer

Orthopaedic Surgeon

University of Tennessee-Campbell Clinic Department of Orthopaedic Surgery & Biomedical Engineering, Memphis, TN
LeBonheur Children's Hospital, Memphis, TN

James H. Beaty

Orthopaedic Surgeon and Department Chairman

University of Tennessee-Campbell Clinic Department of Orthopaedic Surgery & Biomedical Engineering, Memphis, TN

LeBonheur Children's Hospital, Memphis, TN

William C. Warner Jr.

Orthopaedic Surgeon

University of Tennessee-Campbell Clinic Department of Orthopaedic Surgery & Biomedical Engineering, Memphis, TN

LeBonheur Children's Hospital, Memphis, TN

David D. Spence

Orthopaedic Surgeon

University of Tennessee-Campbell Clinic Department of Orthopaedic Surgery & Biomedical Engineering, Memphis, TN

LeBonheur Children's Hospital, Memphis, TN

Derek M. Kelly

Orthopaedic Surgeon

University of Tennessee-Campbell Clinic Department of Orthopaedic Surgery & Biomedical Engineering, Memphis, TN

LeBonheur Children's Hospital, Memphis, TN