Application of Minimally Invasive PHILOS Fixation in the Treatment of Pediatric Subtrochanteric Femur Fractures

Abstract：Objective To summarize the outcome and complications of minimally invasive proximal humerus internal loc-king system( PHILOS)and the nonoperative treatment for pediatric subtrochanteric femur fractures. Methods A total of 24 children with subtrochanteric femur fractures treated with proximal humerus internal locking system and nonoperative treatment between Febrary 2005 and Febrary 2011 were identified. We retrospectively compared 15 children treated with minimally inva-sive proximal humerus internal locking system to 9 children treated nonoperatively. Comparative analysis was performed from the length of hospitalization,time to radiographic union,time to full weightbearing,outcome scores and postoperative complica-tions. Results All 24 patients were followed up for a mean time of 31. 5 months after surgery. The difference in the length of hospitalization,time to radiographic union and time to full weightbearing was significant for the 2 groups(P<0. 05). Outcome scores were significantly better in the proximal humerus internal locking system group(P<0. 05)and the overall complication rate was lower compared with nonoperative group(P<0. 05). Conclusion Our results indicate that minimally invasive proxi-mal humerus internal locking system of pediatric subtrochanteric femur fractures is associated with better outcome scores and a lower overall complication rate when compared with nonoperative group. Minimally invasive proximal humerus internal locking system had became one of the ideal treatment of pediatric subtrochanteric femur fractures.