Archives of Orthopaedic and Trauma Surgery - 2026-03-06 - Journal Article
Outcomes of internal fixation for pediatric proximal femoral fractures using a 3.5 mm T-plate.
Abulsoud MI, Hussiny MG, Nematallah SA, Al Nahhas M, Elsebaey IM, Zayed E, Elhalawany MF, Elgahel MM, Hassanein YA, Shaheen E, Abdou MH, Hassan MM
Topics
Key Takeaway
A contoured 3.5 mm T-plate achieved 100% union at mean 8.7 weeks for pediatric proximal femoral fractures (Delbet types II–V), with good functional outcomes in 64.9% of 37 patients.
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Summary
This study evaluated functional and radiographic outcomes of 3.5 mm T-plate fixation for Delbet type II–V pediatric proximal femoral fractures in 37 children (mean age 8.6 years). All fractures united at a mean of 8.7 weeks; anatomic reduction was achieved in 64.9%, and good functional outcomes in 64.9%, with 8.1% unacceptable reductions. Mean neck-shaft angle deficit versus the contralateral side was 4.9 degrees, and mean neck resorption ratio was 93.8%.
Key Limitation
The absence of a control or comparator fixation group makes it impossible to attribute outcomes to the T-plate construct versus fracture biology or reduction quality alone.
Original Abstract
OBJECTIVE
This study aims to investigate the functional and radiographic outcomes after internal fixation of proximal femoral fractures in children using a 3.5 mm T-plate.
METHODS
From December 2015 to September 2022, all cases presenting with recent proximal femoral fractures were treated with internal fixation using a 3.5 mm T-plate. All patients were followed up for 24 months. Union time, neck shaft angle, neck length, quality of reduction, and functional outcomes were assessed.
RESULTS
The study included 37 patients; the mean age was 8.6+/- 1.6 (6–11) years. Delbet type IV was the most frequent fracture type (13 cases, 35.1%), followed by type V (10 cases, 27%), and type III (9 cases, 24.3%), with type II accounting for 5 cases. All fractures achieved union with a mean time of 8,7 weeks (range 6–12 weeks), As regards radiographic parameters, the mean neck shaft angle difference was 4.9 (SD 3.7) degrees (range 0–16 degrees) less than the contralateral side, the mean neck resorption ratio was 93.8 +/- 4 (range 85–100), The quality of reduction was anatomical in 24 cases (64.9%), acceptable in 10 cases (37%), and considered unacceptable in 3 cases (8.1%), The functional outcome was good in 24 cases (64.9%), fair in 11 patients (29.7%) and poor in two patients (5.4%).
CONCLUSION
The use of a contoured 3.5 mm conventional T-plate in the fixation of recent pediatric femoral fractures (types II–V) yields good results regarding union rates, functional outcome, and maintaining the mechanics of the hip.