Complications Associated with Fracture of the Neck of the Femur in Children

Forlin, Edilson; Guille, James T.; Kumar, S. Jay; Rhee, Kwang Jin

doi:10.1097/01241398-199207000-00017

Cited by 110 publications

(84 citation statements)

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“…This was also observed by Forlin et al [11] and Touzet et al [23]. The angulated fixed nail-plate induces dynamic compression forces; the use of screws leads merely to a static compression.…”

Section: Discussionsupporting

confidence: 73%

Nonunion of fractures of the femoral neck in children

Neto

Reis

Filho

et al. 2008

Journal of Children's Orthopaedics

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The authors present the prospective clinical outcome of nine pseudoarthroses resulting from surgical treatment carried out in nine children, whose ages varied from 6 years and 2 months to 14 years and 2 months (mean 10 years and 2 months), who had fractures of the femoral neck. Five were classified as type II, according to the Delbet classification modified by Colonna, and four were type III. The initial fractures were caused by highenergy traumas, such as trampling, bicycle falls, and car accidents. Treatment of choice was valgus osteotomy of the femoral neck associated or not with insertion of bony graft. The mean time of follow-up was 38 months, ranging from 23 to 71 months, and the mean time of pseudoarthrosis consolidation after osteotomy was 76.6 days, varying from 45 to 240 days. In this study, all the pseudoarthroses consolidated. For final analysis of clinical and radiographic results, the Ratliff's classification was used. We obtained three cases as good results, five as fair and one as poor. The authors concluded that valgus osteotomy is a good option for treatment of pseudoarthrosis in the femoral neck fractures in children.

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Section: Discussionsupporting

confidence: 73%

Nonunion of fractures of the femoral neck in children

Neto

Reis

Filho

et al. 2008

Journal of Children's Orthopaedics

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“…13 There is no effective treatment once avascular necrosis is established. 12 The incidence ranges from 0% 9 to 92%, reported that 71% of displaced fractures developed complications.…”

Section: Discussionmentioning

confidence: 99%

“…1,2,12 We have analysed the longterm results in 18 children who were treated for a displaced fracture of the femoral neck by urgent reduction and internal fixation. Since children are often active and unreliable after operation, and the risks from immobilisation are minimal we used a spica cast in 16 patients for six weeks even although the internal fixation was satisfactory.…”

Section: Discussionmentioning

confidence: 99%

Displaced fractures of the hip in children

Flynn¹,

Wong

Yeh

et al. 2002

The Journal of Bone and Joint Surgery. British volume

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Fractures of the hip in children have been associated with a very high rate of serious complications including avascular necrosis (up to 47%) and coxa vara (up to 32%). Over a period of 20 years, we have treated displaced fractures by early anatomical reduction, internal fixation and immobilisation in a spica cast to try to reduce these complications.We have reviewed 18 patients who had a displaced non-pathological fracture of the hip when under 16 years of age. Their mean age at the time of the injury was eight years (2 to 13). They returned for examination and radiography at a mean follow-up of eight years (2 to 17). Each patient had been treated by early (t 24 hours) closed or open reduction with internal fixation and 16 had immobilisation in a spica cast. By Delbet's classification, there was one type-I, eight type-II, eight type-III, and one type-IV fractures. There were no complications in 15 patients. Avascular necrosis occurred in one patient (type-III), nonunion in one (type-II, one of the two patients who did not have a cast) and premature physeal closure in one (type-I). There were no cases of infection or complications as a result of the cast.Our treatment of displaced hip fractures in children by early reduction, internal fixation, and immobilisation in a spica cast gave reduced rates of complications compared with that of large published series in the literature. Unlike adults, healthy children rarely sustain a fracture of the femoral neck the incidence of which is less than 1% of all paediatric fractures.1 It is usually the result of highenergy injury. Previous studies have reported a high rate of complications, including avascular necrosis, coxa vara, premature physeal closure, nonunion and infection.

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“…Hip fractures occur more frequently in this population than in non-disabled children (3) and they are associated to a higher rate of complications compared to others injuries, such as AVN, non-union, coxa vara, and premature physeal closure (12). The overall complication rate was higher in Delbet type I and II (13), and in neglected fractures (7).…”

Section: Discussionmentioning

confidence: 91%

Surgical treatment of neglected hip fracture in children with cerebral palsy: case report and review of the literature

Toro

Moretti²,

Tirelli

et al. 2017

ccmbm

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SummaryCase. A clinical case of a 15-year-old cerebral palsy child with a Sandhu type 2 neglected femoral neck fracture is presented. The patient was treated using cannulated screws and cancellous bone graft augmented with mesenchymal stem cells. At 6 months after the surgery complete fracture healing was observed. Conclusion. To early diagnose this fractures, it is mandatory to perform a comprehensive clinical and radiological evaluation including also a second level imaging. The use of cannulated screws with cancellous bone graft and MSCs is a viable treatment option in these patients.

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Complications Associated with Fracture of the Neck of the Femur in Children

Cited by 110 publications

References 0 publications

Nonunion of fractures of the femoral neck in children

Nonunion of fractures of the femoral neck in children

Displaced fractures of the hip in children

Surgical treatment of neglected hip fracture in children with cerebral palsy: case report and review of the literature

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