Fractures of the hip in children; treatment and results.

The following are the authors' indications for the treatment of fractures of the hip in children, based on observations in this group of cases and on theoretical considerations: Type I: Transepiphyseal fractures: A. Without dislocation of femoral head: gentle closed manipulation and insertion of two or three parallel Knowles pins. The capsule of the hip joint should not be opened. B. With dislocation of femoral head: open reduction, internal fixation with two or three Knowles pins, and prolonged non-weight-bearing. Type II: Transcervical: gentle closed manipulative reduction and insertion of two or three Knowles pins. The capsule of the hip joint should not be opened. Type III: Cervicotrochanteric: A. If fragments are separated: gentle closed manipulative reduction and insertion of two or three Knowles pins. B. If fragments are not separated: a Hoke-Martin traction cast, or a Whitman abduction cast. Type IV: Intertrochanteric: gentle closed manipulative reduction and application of a Hoke-Martin tractions cast.