Bilateral femoral neck fracture in a child

Abstract

A long-term follow-up of bilateral femoral neck fracture is presented. The patient sustained the injury in a road accident at the age of five. Both fractures were Delbet type III. Three days after the injury, open reduction and internal fixation were performed. A hip spica cast was applied for 8 weeks. Follow-up radiographs show uneventful healing, with no avascular necrosis of the femoral head. The initial shortening of the right proximal femur persisted. The left femur shows extensive remodeling of the femoral head toward valgus. The patient is painless and currently does some sports.

Traumatic simultaneous bilateral femoral neck fracture in a child: A case report

“…3,4,6,7 According to Dhār, 3 early surgery was necessary for a good outcome. Good results, however, were also observed with delayed surgery from two to 77 days with or without skin traction mainly by open reduction 5,6,9,10 (Table I). Our 17-day delay explains the non-anatomic reduction at the right hip.…”

“…All previous cases described in the literature were due to high energy trauma as a result of a motor vehicle accident or fall from a height ( Table I). [2][3][4][5][6][7][8][9][10] In polytrauma cases, it is important to check the hips to avoid a delayed diagnosis. 6 The average age at time of trauma was seven years (range 4-11) and the male to female ratio was 1:1.2.…”

“…In reported cases of traumatic bilateral fracture of femoral neck, three main kinds of mechanisms were hypothesised: a direct 'one-injury fracture', 2 an indirect 'two-injury fracture', 4,6,9 and an indirect axial load fracture: 10 • In the one-injury fractures, the mechanism is a lateral compression (LC) on a fixed pelvis. This mechanism seems similar to the LC type of the Young-Burgess System Classification.…”

“…[2][3][4][5]7,10 It secures the internal fixation for eight weeks on average (range 4-16) without any secondary hip stiffness. The weight bearing time is linked to radiographic signs of bone union.…”

“…1 Bilateral fractures are even rarer, with only ten cases reported in the literature. [2][3][4][5][6][7][8][9][10] Usually, a high energy trauma is involved, such as a fall from a height and motor vehicle accident. 1,4,6,8,11 We report the case of a 9-year-old schoolgirl who presented with traumatic bilateral fractures of the femoral neck after a fall from a height.…”