Clinical and Radiographic Outcomes of Pediatric Femoral Neck Fractures

Abstract

Aim: The aim of this study was to evaluate the clinical and radiological results of pediatric femoral neck fractures and compare the results with the literature.Methods: We retrospectively reviewed patients with the diagnosis of femoral neck fracture who were treated between 2005 and 2012. 14 patients (6 girls, 8 boys) were found in compliance with the follow-up and with a minimum follow-up of 1 year. Causes of the fracture and types of the treatment were investigated from our medical records. Delbet-Colonna classification was used to determine the type of the fractures. At the last follow-up, femoral neck shaft angle (FNSA) and range of motion (ROM) of the affected hip were measured. Outcome was scored according to Ratliff’s assessment criteria. Avascular necrosis (AVN) was classified according to Ratliff’s AVN classification system. Results: The mean age of patients was 9.9 years and the mean follow-up was 35 months. According to Delbet-Colonna classification; 1 patient was type I (7.1%), 4 were type II (28.6%), 8 were type III (57.2%) and 1 was type IV (7.1%). Eight of 14 fractures were displaced (57.2%) and six were non-displaced (42.8%). Eleven of 14 patients had good (78.6 %), 1 had fair (7.1%) and 2 had poor (14.3%) results according to Ratliff’s assessment criteria. According to Ratliff’s AVN classification, 2 patients had Type-III (14.2 %) and 1 had Type-I AVN (7.1 %). Conclusion: According to our results, we recommend anatomical reduction (close or open) and stable internal fixation for the treatment of pediatric femoral neck fractures.