Outcome of Treatment for Pediatric Femoral Neck Fracture

Abstract

Pediatric femoral neck fracture is a relatively rare type of fracture. Herein we report our experience with 10 cases of pediatric femoral neck fracture over the past 10 years with respect to treatment method and clinical evaluations, along with a review of literature. Delbet-Colonna classification was type II (n=2), III (n=5), or IV (n=3). In three patients, healing was achieved with conservative therapy. Among the seven patients who underwent open reduction, coxa vara was observed in two patients and femoral head necrosis in three patients. Outcomes were assessed using Ratliff's criteria as good (n=7) or fair (n=3), with none assessed as poor. Although various studies have been conducted on the prevention of the complications of the pediatric femoral neck fracture, specifically femoral head necrosis, pseudarthrosis and early closure of the epiphyseal lines, but consensus has not been reached. Considering the anatomical characteristics of the femoral neck in children and the causes of pediatric femoral neck fracture, the occurrence of femoral head necrosis following this type of fracture is considered inevitable to some extent, and prevention of coxa vara and early closure of the epiphyseal lines using accurate reduction and internal fixation are important.