Adolescent Hip Fracture-Dislocation: Transphyseal Fracture with Posterior Dislocation of the Proximal Femoral Epiphysis

Nortwick, Sara Van; Beck, Nicholas A.; Li, Mengnai

doi:10.2106/jbjs.cc.15.00271

Cited by 3 publications

(1 citation statement)

References 11 publications

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“…Van Nortwick et al performed a Ganz osteotomy to repair a posterior transphyseal SH III hip fracture-dislocation in a thirteen-year-old male; he had no osteonecrosis or functional limitations at two-year follow-up [ 11 ]. Mehlman et al found that delaying reduction over six hours increased the risk of AVN twenty-fold, and the only factor correlating with development of AVN was length of time between injury and relocation [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Favorable Outcome Twenty-Two Months after Delbet Type Ib Capital Femoral Transepiphyseal Fracture and Posterior Column Acetabular Fracture in a Fifteen-Year-Old Male

Sethuraman

Morse

Guzman

et al. 2022

Case Reports in Orthopedics

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Case. A fifteen-year-old male patient sustained a posteriorly dislocated right capital femoral Delbet type Ib epiphyseal fracture-separation and a right acetabular posterior column fracture after a low-energy trip and fall. The capital femoral epiphysis was closed reduced and fixed with cannulated screws on an urgent basis. He underwent acetabular osteosynthesis via a Kocher-Langenbeck approach two days thereafter. Twenty-two months after injury, he was weight-bearing on the right lower extremity without radiologic evidence of avascular necrosis or clinical evidence of pain or functional deficit. Conclusion. Fracture-separation of the capital femoral epiphysis comprises only 8% of skeletally immature femoral neck fractures in the Delbet and Colonna classification. Prognosis is worse with ipsilateral hip dislocation due to the risk of avascular necrosis from disruption of the medial femoral circumflex artery. Urgent referral to a trauma center and treatment by appropriate specialists enables good long-term results after this uncommon traumatic injury pattern.

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Section: Discussionmentioning

confidence: 99%

Favorable Outcome Twenty-Two Months after Delbet Type Ib Capital Femoral Transepiphyseal Fracture and Posterior Column Acetabular Fracture in a Fifteen-Year-Old Male

Sethuraman

Morse

Guzman

et al. 2022

Case Reports in Orthopedics

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Delbet type Ib trans-epiphyseal separation of femoral neck with posterior acetabular fracture in an adolescent male: A case-based review

Sondur,

Kaushik,

Das

2024

Journal of Orthopaedic Reports

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Traumatic Hip Dislocation Associated with Proximal Femoral Physeal Fractures in Children: A Systematic Review

et al. 2022

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Traumatic hip dislocation might lead to serious complications and a poor outcome. Fortunately, it is a rare condition in pediatric patients. The purpose of this study is to establish and describe the complications caused by hip dislocations associated with transphyseal femoral neck fractures. Therefore, we conducted a literature review that resulted in 11 articles, including 32 patients, older than 10 years of age, suffering from traumatic hip dislocation associated with a transphyseal femoral neck fracture. We presented a case series of three patients with hip fracture-dislocation treated in our clinic that were also evaluated and included in the study. For the 35 patients included in the study group, the percentage of avascular osteonecrosis after hip fracture-dislocation was 88.57%. Traumatic hip dislocation associated with transphyseal femoral neck fracture is a rare condition and has a poor prognosis because of the high incidence of femoral head avascular necrosis (AVN). Reduction should be attempted within six hours the from injury, but this may not minimize the risk of AVN if transphyseal separation occurs. The approach may influence the development of AVN; lateral approach of the hip with great trochanter osteotomy seems to have the lowest number of cases of AVN.

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Adolescent Hip Fracture-Dislocation: Transphyseal Fracture with Posterior Dislocation of the Proximal Femoral Epiphysis

Abstract: Traumatic transepiphyseal fracture-dislocations are rare injuries that commonly result in osteonecrosis. Application of the Ganz surgical hip-dislocation technique to a difficult pediatric hip fracture-dislocation achieved an excellent result.

Cited by 3 publications

References 11 publications

Favorable Outcome Twenty-Two Months after Delbet Type Ib Capital Femoral Transepiphyseal Fracture and Posterior Column Acetabular Fracture in a Fifteen-Year-Old Male

Favorable Outcome Twenty-Two Months after Delbet Type Ib Capital Femoral Transepiphyseal Fracture and Posterior Column Acetabular Fracture in a Fifteen-Year-Old Male

Delbet type Ib trans-epiphyseal separation of femoral neck with posterior acetabular fracture in an adolescent male: A case-based review

Traumatic Hip Dislocation Associated with Proximal Femoral Physeal Fractures in Children: A Systematic Review

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