PREMATURE GREATER TROCHANTERIC EPIPHYSIODESIS SECONDARY TO INTRAMEDULLARY FEMORAL RODDING

Five skeletally immature patients developed premature closure of the g reater trochanteric physis consequent to placement of an intramedullar y rod for primary treatment of a femoral diaphyseal fracture. Each pat ient developed increased femoral neck valgus as compared with the cont ralateral hip. To date, however, none of these patients has had any fu nctional disability, although one has developed mild radiographic subl uxation. In addition, anatomic specimens demonstrated the likelihood o f traversing a portion of the greater trochanteric physis. Other metho ds of fracture treatment, either operative or nonoperative, should be considered in skeletally immature patients who have not entered the fi nal phase of skeletal maturation characterized by subchondral ''sclero sis'' along the greater trochanteric physis.