Children's hip fractures have historically had a bad prognosis. Accurate stable fixation has been one of the factors identified to improve the outcome.
The main problems have been avascular necrosis (AVN) due to disruption of the blood supply, nonunion, and malunion due to unstable fixation.
Extracapsular fractures have a reduced incidence of AVN, but are prone to malunion without stable fixation.
The objective is timely fixation without disruption of the blood supply.
Angularly stable fixation is the solution to malunion. This is the rationale for using a pediatric hip locking plate.