Trochanteric Fractures in Young Children

Abstract

Background: Isolated avulsion fractures of the greater and lesser trochanter are usually seen in adolescents prior to the fusion of the apophysis. Greater trochanter fractures in adults have a high incidence of intertrochanteric extension and lesser trochanter fractures are regarded as a pathognomonic sign of metastatic disease. These fractures are very rare among children.

Methods: We report five cases of trochanteric fractures in children of less than two years of age three of which were unrecognized initially in the accident and emergency department.

Results: Early and complete recovery ensued following immobilization and symptomatic treatment. Surgical intervention was not required.

Conclusions: There needs to be a high index of suspicion to diagnose these fractures in children and plain radiographs need to be carefully examined when assessing a limping child. Our experience shows when correctly diagnosed these injuries can be treated successfully with supportive treatment and no need for surgical intervention.

Level of evidence: IV Case series.