Earlier Time to Reduction Did Not Reduce Rates of Femoral Head Osteonecrosis in Pediatric Hip Fractures

Morscher, Melanie A.; Gothard, M. David; Riley, Patrick

doi:10.1097/bot.0000000000000226

Cited by 37 publications

(35 citation statements)

References 25 publications

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“…The reported incidence of avascular necrosis after femoral neck fractures varies considerably, range from 0 % to 92% in literatures [18,15,5,6,7,8]. The overall rate of osteonecrosis in our study is 10.7%, with type II of 10.5% (2/19 ) and type III 11.1% (1/9), respectively.…”

Section: Discussionmentioning

confidence: 47%

“…It is usually the result of high-energy injury. Previous studies have reported a high risk of severe complications following a pediatric hip fracture [1][2][3][4][5][6][7][8]. As a result of anatomical differences, the complications observed in pediatric patients with hip fracture tend to different from those in adults, making this specific patient population and proper surgical management essential to characterize.…”

Section: Introductionmentioning

confidence: 99%

“…As a result of anatomical differences, the complications observed in pediatric patients with hip fracture tend to different from those in adults, making this specific patient population and proper surgical management essential to characterize. Avascular necrosis (AVN) of the femoral head is the most devastating complication [4], with an incidence ranging from 20% to 29% [5][6][7][8]. The high rate of complications associated with hip fractures is directly related to its tenuous blood supply.…”

Section: Introductionmentioning

confidence: 99%

“…Type I fractures are transphyseal, and types II, III, and IV are transcervical, cervicotrochanteric, and intertrochanteric fractures, respectively. Type II and III are the most common subgroups and often result in avascular necrosis, coxa vara, premature physeal closure, infection and nonunion [1][2][3][4][5][6][7]. Osteonecrosis was more likely to develop in older children because these patients cannot revascularize the femoral head and because they sustain type II, and III fractures more often than do younger children [2].…”

Section: Introductionmentioning

confidence: 99%

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No Negative Influence On Complications of femoral neck fracture Children Age Between 14 And 17 Years Treatment with Cannulated Screws Transphyseal fixation

Liu

Zhao

2020

Preprint

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Background Hip fractures represent less than 1% of pediatric fractures. The physeal of femoral head closure at 14 to 17 years of age, and it provides capacity for spontaneous fracture remodeling. The primary purpose of the current retrospective study was to determine the influence of transphyseal fixation of cancellous screws on the outcomes in this age group. Methods: From April 2007 to August 2016, all patients age between 14 to 17 years with Delbet type II and Type III hip fracture treatment with cancellous screws fixation were included. According to whether the cancellous screws thread across the proximal femur epiphysis, we divided the patients into the no cross epiphysis (NCE) group and cross epiphysis (CE) group. The outcome was analysis regarding osteonecrosis of femoral head, nonunion, delay union, premature physeal closure (PPC), coxa vara and overgrowth of femoral neck. Results: Of the 28 patients were included in the study, most patients were male (92.9%).19 were classified as Delbet type II, 9 were type III. The CE and the NCE group both included 14 patients. The average follow-up time is 37.8 months (range 26-68 months). The rate of superficial infection, deep infection, AVN, non-union, delay union, coxa vara, PCE, overgrowth was not significantly different between the two groups. Conclusion: This study demonstrated that the transphyseal fixation of cannulated screws has no negative influence on the outcomes, especially on femoral head osteonecrosis. Achievement of accurate reduction and rigid fixation for this unique injury is more important than preservation of the proximal femoral epiphysis.

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Section: Discussionmentioning

confidence: 47%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

No Negative Influence On Complications of femoral neck fracture Children Age Between 14 And 17 Years Treatment with Cannulated Screws Transphyseal fixation

Liu

Zhao

2020

Preprint

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“…As patients younger than 10 years of age have a greater remodeling capacity, the functional results are better in these patients, and the complication rates are lower [22,23]. However, the age factor is a subject of controversy in the literature [8,21].…”

Section: Discussionmentioning

confidence: 95%

Early prediction of outcomes in hip fractures

Baysal

Ecevız

Bulut

et al. 2016

Journal of Pediatric Orthopaedics B

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We retrospectively analyzed the surgical treatment of 28 pediatric hip fractures. The majority of cases were Delbet type 2 (57%) and type 3 (29%). The average age of the patients was 10.8 years (range: 2-16 years). The mean follow-up period was 91 months. Displaced fractures were found in 18 cases (64%). The major factor in the development of avascular necrosis was the degree of displacement at the time of initial presentation (P<0.05), irrespective of fracture type. Although the degree of initial displacement cannot be prevented, careful exposure of soft tissue during open reduction will reduce avascular necrosis.

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Femoral Neck Fractures in Children

Fisher¹,

Riley²,

Bono³

2018

Pediatric Orthopedic Trauma Case Atlas

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Earlier Time to Reduction Did Not Reduce Rates of Femoral Head Osteonecrosis in Pediatric Hip Fractures

Abstract: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

Cited by 37 publications

References 25 publications

No Negative Influence On Complications of femoral neck fracture Children Age Between 14 And 17 Years Treatment with Cannulated Screws Transphyseal fixation

No Negative Influence On Complications of femoral neck fracture Children Age Between 14 And 17 Years Treatment with Cannulated Screws Transphyseal fixation

Early prediction of outcomes in hip fractures

Femoral Neck Fractures in Children

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