OBJECTIVETo compare the radiographic and functional outcomes of nonoperative and minimally invasive methods in treating femoral subtrochanteric fractures in children.

METHODSForty-five children (male 28, female 17) aging from 4- to 15-years-old with femoral subtrochanteric fracture were managed with traction and cast application (16 cases), and elastic intramedullary nailing (29 cases). Early and late radiologic outcomes were respectively evaluated by Beaty and Theologis criteria. The outcomes of clinical effect were evaluated with Sanders scoring system.

RESULTSAll patients were followed up from 26 to 62 months with an average of 39.5 months. The fractures united in 45 patients. Early (at 4th week after treatment) satisfactory radiologic outcomes were respectively 6 cases and 26 cases between two methods of nonoperative and minimally invasive. Late (at 2nd year after treatment) satisfactory radiologic outcomes were respectively 11 cases and 28 cases between two methods of nonoperative and minimally invasive. According to Sanders scoring, 12 cases were excellent, 4 good with nonoperative methods; and 28 excellent, 1 good with minimally invasive methods. There were significant differences between the two groups in aforesaid aspect.

CONCLUSIONMinimally invasive methods provided more satisfactory alignment of fractures as well as better functional outcomes than nonoperative methods. It is the first choice to treat femoral subtrochanteric fractures in children.