There is a lack of agreement regarding definition of the fractures .
Mathew and Jeffrey: it is subtrochanteric femoral fracture in pediatrics when the fracture distance is less than 10% from lesser trochanter compared to total shaft length , an area in which the muscle deforming action results in difficulty to control reduction
Modalities of internal fixation include:
. titanium elastic nails (TEN)
. cephalomedullary nails (CM)
. interlocking nails
. Smith Peterson plates
. plate and hip screw
. nail and intramedullary hip screw and cancellous screws.
For the management of this injury we use trochanteric antigrade nail (TAN), a rigid intramedullary nail with a trochanteric entry point
Purpose is to decrease wound dissection and to provide secure fixation that will enhance ambulation and full weight bearing which in turn will make a more satisfactory post-operative period, thus a quicker return to pre-operative activities, and augment bone healing