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

Publication date: Available online 2 February 2019

Source: Injury

Author(s): Vito Pavone, Gianluca Testa, Maria Riccioli, Antonio Di Stefano, Giuseppe Condorelli, Giuseppe Sessa

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 hours 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.

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