Transtrochanteric Transverse Fracture of Proximal Femur in Pediatric Child: A Rare Variant: Case Report and Surgical Management

Introduction: Femoral fractures in the transtrochanteric region and avulsion of the greater trochanter in skeletally immature individuals occur due to high-energy trauma. Due to the unique anatomy and blood supply of the proximal femur in growing children, these fractures are notorious for high rate...

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Main Authors: S Rohinth, KR Tarun Prashanth, M R Thirunthaiyan, R Dorai Kumar, B Sundararaja
Format: Article
Language:English
Published: Indian Orthopaedic Research Group 2025-06-01
Series:Journal of Orthopaedic Case Reports
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Online Access:https://jocr.co.in/wp/2025/06/01/transtrochanteric-transverse-fracture-of-proximal-femur-in-pediatric-child-a-rare-variant-case-report-and-surgical-management/
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author S Rohinth
KR Tarun Prashanth
M R Thirunthaiyan
R Dorai Kumar
B Sundararaja
author_facet S Rohinth
KR Tarun Prashanth
M R Thirunthaiyan
R Dorai Kumar
B Sundararaja
author_sort S Rohinth
collection DOAJ
description Introduction: Femoral fractures in the transtrochanteric region and avulsion of the greater trochanter in skeletally immature individuals occur due to high-energy trauma. Due to the unique anatomy and blood supply of the proximal femur in growing children, these fractures are notorious for high rates of complications despite appropriate management. Classification of these fractures is done according to the Delbet system and AO classification, which not only guides management but also provide prognostic clues. Multiple fixation methods have been described, and there is no consensus on what constitutes the best treatment. Non-union, coxa vara, and pre-mature physeal arrest are the most frequent complications. The association of a transverse transtrochanteric proximal femur fracture with avulsion of the greater trochanter in a young patient, to the best of our knowledge, has not been previously described in the literature. Case Report: We present the case of a 16-year-old boy who sustained an injury to the right hip following a high-velocity road traffic accident. Initial clinical examination revealed severe swelling and tenderness in the hip joint, and imaging confirmed a transtrochanteric transverse fracture with a greater trochanter avulsion fracture. Higher imaging, such as computed tomography, was performed to understand the fracture anatomy. Surgical management involved open reduction and internal fixation of the proximal femur. Post-operative rehabilitation focused on joint mobility and strength, and the patient achieved full weight-bearing and near-complete range of motion by 3 months. Conclusion: A transtrochanteric transverse fracture with greater trochanter avulsion requires appropriate surgical intervention, which helps in early mobilization and prevents long-term complications.
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spelling doaj-art-4083eb681d4441d3b08821e8dcb95e302025-08-20T03:22:12ZengIndian Orthopaedic Research GroupJournal of Orthopaedic Case Reports2250-06852321-38172025-06-0115613113510.13107/jocr.2025.v15.i06.5690Transtrochanteric Transverse Fracture of Proximal Femur in Pediatric Child: A Rare Variant: Case Report and Surgical ManagementS RohinthKR Tarun PrashanthM R ThirunthaiyanR Dorai KumarB SundararajaIntroduction: Femoral fractures in the transtrochanteric region and avulsion of the greater trochanter in skeletally immature individuals occur due to high-energy trauma. Due to the unique anatomy and blood supply of the proximal femur in growing children, these fractures are notorious for high rates of complications despite appropriate management. Classification of these fractures is done according to the Delbet system and AO classification, which not only guides management but also provide prognostic clues. Multiple fixation methods have been described, and there is no consensus on what constitutes the best treatment. Non-union, coxa vara, and pre-mature physeal arrest are the most frequent complications. The association of a transverse transtrochanteric proximal femur fracture with avulsion of the greater trochanter in a young patient, to the best of our knowledge, has not been previously described in the literature. Case Report: We present the case of a 16-year-old boy who sustained an injury to the right hip following a high-velocity road traffic accident. Initial clinical examination revealed severe swelling and tenderness in the hip joint, and imaging confirmed a transtrochanteric transverse fracture with a greater trochanter avulsion fracture. Higher imaging, such as computed tomography, was performed to understand the fracture anatomy. Surgical management involved open reduction and internal fixation of the proximal femur. Post-operative rehabilitation focused on joint mobility and strength, and the patient achieved full weight-bearing and near-complete range of motion by 3 months. Conclusion: A transtrochanteric transverse fracture with greater trochanter avulsion requires appropriate surgical intervention, which helps in early mobilization and prevents long-term complications.https://jocr.co.in/wp/2025/06/01/transtrochanteric-transverse-fracture-of-proximal-femur-in-pediatric-child-a-rare-variant-case-report-and-surgical-management/transtrochanteric fracturegreater trochanter avulsiondynamic hip screw
spellingShingle S Rohinth
KR Tarun Prashanth
M R Thirunthaiyan
R Dorai Kumar
B Sundararaja
Transtrochanteric Transverse Fracture of Proximal Femur in Pediatric Child: A Rare Variant: Case Report and Surgical Management
Journal of Orthopaedic Case Reports
transtrochanteric fracture
greater trochanter avulsion
dynamic hip screw
title Transtrochanteric Transverse Fracture of Proximal Femur in Pediatric Child: A Rare Variant: Case Report and Surgical Management
title_full Transtrochanteric Transverse Fracture of Proximal Femur in Pediatric Child: A Rare Variant: Case Report and Surgical Management
title_fullStr Transtrochanteric Transverse Fracture of Proximal Femur in Pediatric Child: A Rare Variant: Case Report and Surgical Management
title_full_unstemmed Transtrochanteric Transverse Fracture of Proximal Femur in Pediatric Child: A Rare Variant: Case Report and Surgical Management
title_short Transtrochanteric Transverse Fracture of Proximal Femur in Pediatric Child: A Rare Variant: Case Report and Surgical Management
title_sort transtrochanteric transverse fracture of proximal femur in pediatric child a rare variant case report and surgical management
topic transtrochanteric fracture
greater trochanter avulsion
dynamic hip screw
url https://jocr.co.in/wp/2025/06/01/transtrochanteric-transverse-fracture-of-proximal-femur-in-pediatric-child-a-rare-variant-case-report-and-surgical-management/
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AT krtarunprashanth transtrochanterictransversefractureofproximalfemurinpediatricchildararevariantcasereportandsurgicalmanagement
AT mrthirunthaiyan transtrochanterictransversefractureofproximalfemurinpediatricchildararevariantcasereportandsurgicalmanagement
AT rdoraikumar transtrochanterictransversefractureofproximalfemurinpediatricchildararevariantcasereportandsurgicalmanagement
AT bsundararaja transtrochanterictransversefractureofproximalfemurinpediatricchildararevariantcasereportandsurgicalmanagement