Minimally Invasive Percutaneous Plate Osteosynthesis with Proximal Humerus Locking Plate for Pediatric Comminuted Subtrochanteric Femur Fracture: A Case Report

Pediatric subtrochanteric femoral fractures are uncommon, constituting only 4-10% of pediatric femoral fractures. These fractures present a significant challenge due to the strong muscular forces often resulting in malalignment, complicating treatment and reduction. This case is particularly noteworthy as it involves a comminuted subtrochanteric fracture, which is even rarer and demands advanced surgical intervention. This is one of the few reported cases of using a proximal humerus locking plate for treating a comminuted subtrochanteric femoral fracture in a pediatric patient. A 6-year-old girl presented with a closed injury to her left thigh resulting from a twisting injury and fall while playing. She was clinically and radiologically diagnosed with a left proximal femur comminuted subtrochanteric fracture extending into the diaphysis. She was also overweight for her age. Given the patient's age, the comminuted nature of the fracture, and the need for early mobilization, a decision was made to treat the fracture surgically. A minimally invasive technique used a proximal humerus locking plate to stabilize the fracture. The fracture healed uneventfully, and later, implant removal was also done. This case report presents a successful case wherein a proximal humerus locking plate was effectively utilized to manage a comminuted subtrochanteric femoral fracture in a pediatric patient. The innovative utilization of this implant, typically designated for proximal humerus fractures, underscores its adaptability and effectiveness in achieving secure fixation and facilitating recovery in intricate pediatric femur fractures. This strategy has the potential to significantly influence orthopedic practices by offering a feasible alternative for addressing challenging comminuted subtrochanteric fractures in children, potentially enhancing outcomes and decreasing complications linked with more traditional approaches.