Surgical treatment with cannulated screws for pediatric femoral neck fractures: A case series

Injury. 2019 Jul:50 Suppl 2:S40-S44. doi: 10.1016/j.injury.2019.01.043. Epub 2019 Feb 2.

Abstract

Introduction: Femoral neck fractures are uncommon injuries in children, but the high incidence of long-term complications makes it important clinical entity. Early surgical treatment to achieve optimal results and to avoid a high rate of complications is widely advised. The purpose of this study was to retrospectively analyze the outcome of 8 children who sustained a femoral neck fracture.

Patients and methods: The patients (6 boys and 2 girls with an average age of 9.2 years) were treated within 24 h following admission to hospital by closed reduction and internal fixation. The type of fracture was distinguished according to Delbet's classification system. The outcome was analyzed using Ratliff's criteria, and a detailed record of complications was maintained.

Results: According Delbet's classification system, there were 3 type I, 2 type II, 2 type III, and 1 type IV fractures. The average follow-up was 39.2 months (range 8-95). A satisfactory outcome was obtained in 6 (75%) children. Avascular necrosis was the most notable complication, which was reported in the 2 fair outcomes (25%).

Conclusions: Early and aggressive surgical treatment aimed at anatomical reduction result in a satisfactory outcome in pediatric femur neck fractures. Development of avascular necrosis is the main complication.

Keywords: Avascular necrosis; Cannulated screws; Femoral neck fracture; Hip decompression; Pediatric age; Reduction and fixation.

MeSH terms

  • Adolescent
  • Bone Screws
  • Case-Control Studies
  • Child
  • Female
  • Femoral Neck Fractures / classification
  • Femoral Neck Fractures / diagnostic imaging
  • Femoral Neck Fractures / physiopathology
  • Femoral Neck Fractures / surgery*
  • Femur Neck / blood supply*
  • Femur Neck / diagnostic imaging
  • Follow-Up Studies
  • Fracture Fixation, Internal*
  • Fracture Healing / physiology*
  • Humans
  • Male
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / physiopathology
  • Postoperative Complications / surgery*
  • Radiography
  • Retrospective Studies
  • Treatment Outcome