Fracture of the femoral neck in children : Butler J. E. and Cary J. M. (1972), ‘Fracture of the femoral neck in a child’, J. Am. med. Ass., 218, 398

Abstract

The femoral neck fractures in children are very rare. It is difficult to elaborate a standard of treatment of this disorder in children, because of a little amount of publications on this subject. The common complications which occur are physis premature closure, coxa vara, avascular necrosis of the head and neck of femur and ocasionally nonunion. The paper analyses 18 cases of fracture in children at the age of 4 to 16 years old (average 8 years old) who were treated at the clinic since 1990 to 2003. Cohort of patients included 7 boys and 11 girls. Fractures were classified according to Delbet: 4 cases of type II and 14 cases of type III. In 17 cases left and in 1 case right femur was involved. Operative treatment was performed by means of open reduction (anterior approach), and internal fixation: in 10 cases fixation with lag screws for cancellous bone; in 2 cases with lag screw and Kirschner wire; in 1 case fixation with angular blade. Postoperatively patients were placed in hip spica cast for 6 weeks. Full weightbearing was allowed after fracture united and AVN was excluded. Follow up time was from 1.5 to 12 years (average 6 years). Outcomes were analysed according to the fracture type and treatment kind. Functional and radiologic results were evaluated according to Ratliff's score. Basing on the analysed material, the authors of the essay conclude that patients with femoral neck fracture type II and type III according to Delbet, who had dislocation of the part of bone femur should have a surgical treatment applied, while the non-surgical treatment should be applied with the patients who have femoral neck fracture with no dislocation of the part of bone femur.