Surgical Discussion

Patient positioning:  Supine position on a radiolucent table to facilitate intraoperative imaging and access to the femoral neck.

Anatomical surgical approach:  A modified Smith-Petersen approach was utilized, involving an incision along the anterior aspect of the hip, allowing for direct visualization of the femoral neck. Subperiosteal dissection was performed to expose the fracture site without compromising the surrounding musculature. A separate lateral approach was employed for the application of fixation devices.

The surgeon emphasized the importance of achieving a high-quality reduction and stable fixation due to the displacement pattern of the fracture. A meticulous surgical approach was critical to avoid malreduction, which is not well-tolerated in pediatric patients. The modified Smith-Petersen approach provided excellent visualization for anatomic reduction, minimizing soft tissue damage.

Postoperative protocol:   Postoperative rehabilitation included non-weight bearing status initially, with gradual progression to weight-bearing as tolerated. Range of motion exercises were initiated early to prevent joint stiffness.

Follow up:   Not specified

Orthopaedic implants used:   Angle stable static device (specific brand not mentioned).