{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:11:29Z","timestamp":1753891889160,"version":"3.41.2"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T00:00:00Z","timestamp":1700611200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Treating subtrochanteric femur fractures in pediatric patients remains challenging, and an optimal fixation device has yet to be established. This study aimed to asess the clinical and radiological outcomes of Ortho-Bridge System (OBS) treatment for length-unstable subtrochanteric femur fractures in children aged 5\u201316 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective review of pediatric patients with subtrochanteric femur fractures treated with OBS between January 2018 and December 2021. The study included 19 children (12 boys, 7 girls) with an average age of 10.4\u2009\u00b1\u20092.6 years. Two of the patients had pathological fractures associated with aneurysmal bone cyst. Demographic information, mechanism of accident, fracture type, associated neurovascular injuries, surgical duration and blood loss, were collected from the hospital database. Time to union and postoperative complications were recorded. Clinical and radiological outcomes were assessed using the Harris scoring system at the latest follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Injuries resulted from vehicle accidents in 10 patients (52.6%), falls over 3 meters in height in 3 patients (15.8%), and sports-related injuries in 6 patients (31.6%). The average patient weight was 41.5\u2005kg (range: 21\u201378). Of the fractures, 14 (73.7%) were complex, and 5 (26.3%) were spiral. The average surgical duration was 111\u2005min (range: 90\u2013180), and the average surgical blood loss was 134\u2005ml (range: 70\u2013300). The mean time to union was 12.7 weeks (range: 8\u201316). No cases of infection, malunion, implant failure, or femoral head osteonecrosis were reported. Leg length discrepancy of 10\u2005mm was observed in one patient. All patients achieved excellent results according to the Harris scoring system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study suggests that the OBS may serve as an effective alternative fixation option for managing length-unstable subtrochanteric femur fractures in school-aged children.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2023.1306076","type":"journal-article","created":{"date-parts":[[2023,11,23]],"date-time":"2023-11-23T16:04:18Z","timestamp":1700755458000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Role of the ortho-bridge system in the length unstable subtrochanteric femur fracture in school going children: a retrospective clinical study of 19 cases"],"prefix":"10.3389","volume":"11","author":[{"given":"Mingjing","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiang","family":"Xiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunquan","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zonghui","family":"Dai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fan","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,11,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"103","DOI":"10.3928\/0147-7447-20000201-10","article-title":"Custom 95 degree condylar blade plate for pediatric subtrochanteric femur fractures","volume":"23","author":"Segal","year":"2000","journal-title":"Orthopedics"},{"key":"B2","doi-asserted-by":"publisher","first-page":"610","DOI":"10.3390\/medicina58050610","article-title":"Clinical characteristics and distribution of pediatric fractures at a tertiary hospital in northern France: a 20-year-distance comparative analysis (1999-2019)","volume":"58","author":"Monget","year":"2022","journal-title":"Medicina (Kaunas)"},{"key":"B3","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1097\/01.bpo.0000203005.50906.41","article-title":"The definition and treatment of pediatric subtrochanteric femur fractures with titanium elastic nails","volume":"26","author":"Pombo","year":"2006","journal-title":"J Pediatr Orthop"},{"key":"B4","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1034\/j.1600-0501.1997.080412.x","article-title":"Subtrochanteric femoral fractures in children. Alignment after 90 degrees-90 degrees traction and cast application","volume":"341","author":"Jeng","year":"1997","journal-title":"Clin Orthop Relat Res"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/BPB.0000000000000766","article-title":"Can titanium elastic nail be safely used for paediatric subtrochanteric femur fractures?","volume":"30","author":"Basa","year":"2021","journal-title":"J Pediatr Orthop B"},{"key":"B6","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1097\/01.ta.0000197606.63124.9e","article-title":"Management of subtrochanteric fractures in skeletally immature adolescents","volume":"60","author":"Jarvis","year":"2006","journal-title":"J Trauma"},{"key":"B7","doi-asserted-by":"publisher","first-page":"718","DOI":"10.5435\/00124635-200911000-00006","article-title":"Treatment of pediatric diaphyseal femur fractures","volume":"17","author":"Kocher","year":"2009","journal-title":"J Am Acad Orthop Surg"},{"key":"B8","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1097\/BPB.0000000000000699","article-title":"Enhancing stability by penetrating the apophysis of greater trochanter or the posterior neck cortex during titanium elastic nailing of paediatric subtrochanteric femoral fractures in children aged 5-12 years","volume":"29","author":"Cha","year":"2020","journal-title":"J Pediatr Orthop B"},{"key":"B9","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1186\/s13018-022-03154-w","article-title":"Femoral periprosthetic fracture treatment using the ortho-bridge system: a biomechanical study","volume":"17","author":"Long","year":"2022","journal-title":"J Orthop Surg Res"},{"key":"B10","doi-asserted-by":"publisher","first-page":"347","DOI":"10.5435\/00124635-200409000-00009","article-title":"Management of pediatric femoral shaft fractures","volume":"12","author":"Flynn","year":"2004","journal-title":"J Am Acad Orthop Surg"},{"key":"B11","doi-asserted-by":"publisher","first-page":"737","DOI":"10.2106\/00004623-196951040-00012","article-title":"Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation","volume":"51","author":"Harris","year":"1969","journal-title":"J Bone Joint Surg Am"},{"key":"B12","doi-asserted-by":"publisher","first-page":"2797","DOI":"10.1007\/s11999-013-2931-9","article-title":"Submuscular bridge plating for complex pediatric femur fractures is reliable","volume":"471","author":"Abdelgawad","year":"2013","journal-title":"Clin Orthop Relat Res"},{"key":"B13","doi-asserted-by":"publisher","first-page":"2735","DOI":"10.1007\/s11999-013-3240-z","article-title":"Elastic nailing for pediatric subtrochanteric and supracondylar femur fractures","volume":"472","author":"Parikh","year":"2014","journal-title":"Clin Orthop Relat Res"},{"key":"B14","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1007\/s11751-016-0252-8","article-title":"External fixation of paediatric subtrochanteric fractures using calcar rather than neck pins","volume":"11","author":"Galal","year":"2016","journal-title":"Strategies Trauma Limb Reconstr"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1188","DOI":"10.4103\/jfmpc.jfmpc_1210_20","article-title":"Role of mini-invasive bridge plate in the complex femoral fracture in school going children:a prospective clinical study of 30 cases","volume":"10","author":"Lakhani","year":"2021","journal-title":"J Family Med Prim Care"},{"key":"B16","doi-asserted-by":"publisher","first-page":"894262","DOI":"10.3389\/fped.2022.894262","article-title":"Operative choice for subtrochanteric femoral fracture in school-aged children: triple elastic stable intramedullary nail versus locking plate","volume":"10","author":"Hong","year":"2022","journal-title":"Front Pediatr"},{"key":"B17","doi-asserted-by":"publisher","first-page":"e828","DOI":"10.1097\/BPO.0000000000002207","article-title":"An alternative fixation option for subtrochanteric femur fractures in children: adult proximal humerus plate","volume":"42","author":"Dani\u015fman","year":"2022","journal-title":"J Pediatr Orthop"},{"key":"B18","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1097\/01.bpo.0000164872.44195.4f","article-title":"Complications of pediatric femur fractures treated with titanium elastic nails: a comparison of fracture types","volume":"25","author":"Sink","year":"2005","journal-title":"J Pediatr Orthop"},{"key":"B19","doi-asserted-by":"publisher","first-page":"e7","DOI":"10.1097\/BOT.0000000000000156","article-title":"The management of pediatric subtrochanteric femur fractures with a statically locked intramedullary nail","volume":"29","author":"Herrera-Soto","year":"2015","journal-title":"J Orthop Trauma"},{"key":"B20","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1097\/BPO.0b013e318288b496","article-title":"Comparison of titanium elastic nail and plate fixation of pediatric subtrochanteric femur fractures","volume":"33","author":"Li","year":"2013","journal-title":"J Pediatr Orthop"},{"key":"B21","doi-asserted-by":"publisher","first-page":"68","DOI":"10.55095\/achot2022\/009","article-title":"Pathological fractures of the proximal femur in children and adolescents treated with LCP paediatric hip plate","volume":"89","author":"Patrikov","year":"2022","journal-title":"Acta Chir Orthop Traumatol Cech"},{"key":"B22","doi-asserted-by":"publisher","first-page":"899","DOI":"10.1177\/0954411914548866","article-title":"Biomechanical analysis and clinical effects of bridge combined fixation system for femoral fractures","volume":"228","author":"Wang","year":"2014","journal-title":"Proc Inst Mech Eng H"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2023.1306076\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,23]],"date-time":"2023-11-23T16:04:20Z","timestamp":1700755460000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2023.1306076\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,22]]},"references-count":22,"alternative-id":["10.3389\/fped.2023.1306076"],"URL":"https:\/\/doi.org\/10.3389\/fped.2023.1306076","relation":{},"ISSN":["2296-2360"],"issn-type":[{"type":"electronic","value":"2296-2360"}],"subject":[],"published":{"date-parts":[[2023,11,22]]},"article-number":"1306076"}}