Pediatric proximal femur

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31-E/1.1 - Traumatic epiphysiolysis, SH I Please select a treatment option:
Treatment	Main indication	Skill	Equipment
Hip spica	Stable, incomplete, or virtually nondisplaced fracture in a younger child
In situ fixation with K-wires or screws	Stable, incomplete, or virtually nondisplaced fractures
Open reduction, K-wire fixation	Displaced fracture in younger children, angular stability not required
Open reduction, screw fixation	Displaced fracture in younger children, angular stability not required

31-E/2.1 - Epiphysiolysis with metaphyseal wedge, SH II Please select a treatment option:
Treatment	Main indication	Skill	Equipment
Hip spica	Stable, incomplete, or virtually nondisplaced fracture in a younger child
In situ fixation with K-wires or screws	Stable, incomplete, or virtually nondisplaced fractures
Open reduction, K-wire fixation	Displaced fracture in younger children, angular stability not required
Open reduction, screw fixation	Displaced fracture in younger children, angular stability not required
Open reduction, pediatric hip locking plate	Salter-Harris II fractures with a large metaphyseal fragment

31-E/7 - Avulsion of/by the ligament of the head of the femur Please select a treatment option:
Treatment	Main indication	Skill	Equipment
Removal of osteochondral fragment	Small fragments which cannot be fixed
Open reduction, resorbable pin fixation	Fragments that are largely cartilaginous
Open reduction, headless screw fixation	Osteochondral fragments with enough bone for screw fixation

31-E/8 - Intraarticular flake(s) Please select a treatment option:
Treatment	Main indication	Skill	Equipment
Removal of osteochondral fragment	Small fragments which cannot be fixed
Open reduction, resorbable pin fixation	Fragments that are largely cartilaginous
Open reduction, headless screw fixation	Osteochondral fragments with enough bone for screw fixation

31-M/2.1 I - Incomplete midcervical Please select a treatment option:
Treatment	Main indication	Skill	Equipment
Hip spica	Stable, incomplete fracture in a younger child
In situ fixation with K-wires or screws	Stable, incomplete fracture
Pediatric hip locking plate	Incomplete fractures that require angular stability to avoid later displacement (more distal fracture, eg, basicervical, trochanteric)

31-M/2.1 II - Incomplete basicervical Please select a treatment option:
Treatment	Main indication	Skill	Equipment
Hip spica	Stable, incomplete fracture in a younger child
In situ fixation with K-wires or screws	Stable, incomplete fracture
Pediatric hip locking plate	Incomplete fractures that require angular stability to avoid later displacement (more distal fracture, eg, basicervical, trochanteric)

31-M/2.1 III - Incomplete transtrochanteric Please select a treatment option:
Treatment	Main indication	Skill	Equipment
Hip spica	Stable, incomplete fracture in a younger child
In situ fixation with K-wires or screws	Stable, incomplete fracture
Pediatric hip locking plate	Incomplete fractures that require angular stability to avoid later displacement (more distal fracture, eg, basicervical, trochanteric)

31-M/3.1 I - Complete midcervical, simple Please select a treatment option:
Treatment	Main indication	Skill	Equipment
Open reduction, K-wire fixation	Displaced fracture in younger children, pediatric hip locking plate, or equivalent, not available
Open reduction, screw fixation	Displaced fracture in a more proximal location
Open reduction, pediatric hip locking plate	Method of choice for any displaced fracture

31-M/3.1 II - Complete basicervical, simple Please select a treatment option:
Treatment	Main indication	Skill	Equipment
Open reduction, K-wire fixation	Displaced fracture in younger children, pediatric hip locking plate, or equivalent, not available
Open reduction, screw fixation	Displaced fracture in a more proximal location
Open reduction, pediatric hip locking plate	Method of choice for any displaced fracture

31-M/3.2 II - Complete basicervical, multifragmentary Please select a treatment option:
Treatment	Main indication	Skill	Equipment
Open reduction, pediatric hip locking plate	Method of choice for any displaced fracture

31-M/3.1 III - Complete, transtrochanteric, simple Please select a treatment option:
Treatment	Main indication	Skill	Equipment
Open reduction, pediatric hip locking plate	All trochanteric fractures
ESIN	Children up to 6-8 years of age (depending on body size)

31-M/3.2 III - Complete transtrochanteric, multifragmentary Please select a treatment option:
Treatment	Main indication	Skill	Equipment
Open reduction, pediatric hip locking plate	All trochanteric fractures
ESIN	Children up to 6-8 years of age (depending on body size)

31-M/7 - Avulsion of the greater or lesser trochanter Please select a treatment option:
Treatment	Main indication	Skill	Equipment
Nonoperative treatment	Displacement < 1.5-2.0 cm for the lesser trochanter and < 1 cm for the greater trochanter
Open reduction, tension band (greater trochanter)	Displacement > 1 cm, split avulsion fragment
Open reduction, screw fixation (greater trochanter)	Displacement > 1 cm, intact fragment

*Skill
	Basic surgical experience, no specialized skills
	Some specialized surgical experience
	Highly experienced and skilled surgeon

*Equipment
	Basic equipment only
	Simple surgical and imaging resources
	Full specialized surgical and imaging resources

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v1.0 2017-12-04