Retrospective analysis of 35 pediatric femoral neck fractures

Eur J Orthop Surg Traumatol. 2022 Oct;32(7):1385-1390. doi: 10.1007/s00590-021-03126-6. Epub 2021 Sep 20.

Abstract

Objective: Pediatric proximal femur fracture is extremely rare trauma comparing to other fractures. The proximal femur fracture is 1% of all pediatric fractures. The aim of current study is to compare the incidence of early complications and outcomes of pediatric proximal femur fractures regarding fracture types retrospectively.

Design: Our study includes 35 cases which are criticized by Delbet classification system, modalities of treatment, duration of waiting for surgery, duration of follow-up and also complications. Our inclusion criteria are age below 16 years old, proximal femur fractures with no evidence of tumoral, romathologic and methabolic conditions. Age, sex and surgery type (open-closed) were noted, and the data were statistically assessed. Assessment of the final outcome was made at the last follow-up visit using the Ratliff's method.

Results: The mean of age of patients in our study is 9.5 ± 5.06 years. The average follow-up was 25.6 ± 13.2 months. 15 patients (42.9%) are type 2 Delbet fracture, 5 patients (14.2%) are Delbet type 3 and 15 patients (42.9%) are Delbet type 4 fracture. Using the Ratliff's method, 25 patients (71.4%) had satisfactory outcomes. Ten patients (28.6%) had unsatisfactory outcomes. The complications as AVN, coxa vara and premature closure of physis, non-union and postoperative infections have been detected in this study. AVN was seen in four (11.4%) patients. In addition, coxa vara was seen in six (17.2%) patients.

Conclusion: Pediatric femoral neck fractures are extremely rare fractures and can be treated with low complication rates in cases with early treatment and anatomic reduction.

Keywords: Avascular necrosis; Coxa vara; Osteonecrosis; Pediatric femoral neck fracture.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Coxa Vara*
  • Femoral Fractures* / complications
  • Femoral Fractures* / surgery
  • Femoral Neck Fractures* / complications
  • Fracture Fixation, Internal / adverse effects
  • Fracture Fixation, Internal / methods
  • Humans
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Treatment Outcome