Management of pediatric femoral neck fractures: A prospective study

Abstract

Introduction: Pediatric femoral neck fracture is an uncommon injury with a high complication rate, regardless of the appropriate diagnosis and management. The bony anatomy and blood supply of the proximal femur in a skeletally immature patient differs from those in adult patients. Pediatric femoral neck fractures are categorized using the Delbert classification system. This classification guides management and aids clinicians in determining the risk of avascular osteonecrosis. Aim and Objective: Aim of this study was to develop a guideline for the management of femoral neck fracture in children rapidly and accurately with fewer complications based on the best available scientific evidence. Materials and Methods: Thirteen children with fractures of femoral neck were included in this study. The enrolled patients presented in the emergency department of Bone and Joint Hospital, an associated hospital of Govt. Medical College Srinagar from June 2019- May 2020. Results: Using the clinical and radiological assessment by the Ratliff system, 9 (69.23%) patients had a good clinical outcome and 4 (30.77%) had fair outcomes. We did not encounter any patients with a poor outcome in our series. Of the 4 patients with fair outcomes, 3 had AVN and coxa Vara and 1 had a deep-seated infection of the hip leading to arthritic changes of the hip. Conclusion: In the management of pediatric femoral neck fractures, the early closed reduction and fixation may be effective to improve results and prevent long-term complications.