Pediatric Femoral Neck Fractures: Our Institutional Experience of 5 Years

Abstract

Introduction Pediatric femoral neck fractures remain an enigma for orthopaedics, especially with regard to the development of avascular necrosis (AVN). These rare fractures are fraught with complications including non-union, coxa vara, premature physeal closure, and AVN. Aggressive urgent management is required to limit the development of complications. We aim to share our institutional experience of 10 such cases, spanning over a period of 5 years by analyzing the radiological and clinical outcomes after anatomical reduction and internal fixation. Materials and Methods Ten children, aged < 16 years with fractured neck of the femur, treated in our hospital with a minimum follow-up of 1 year, were retrospectively reviewed and radiological and clinical outcomes following anatomical reduction and internal fixation were analyzed. Written informed consent was taken from the parents of the children included in the study. Results The mean age was 9.6 years. In total, 60% of the cases were boys and 50% cases were due to road traffic accidents (RTA). Furthermore, 50% cases were of Delbet type II pattern, 30% Delbet type III, and 20% Delbet type IV. All patients were treated with anatomical reduction and internal fixation. The final outcome was good in 80% of cases and fair in 20% of cases. We encountered only one case of AVN in our series. Conclusion Aggressive, urgent anatomical reduction and stable internal fixation is the modality of treatment. The outcome in patients is influenced by the development of complications including AVN, limb length discrepancy, and coxa vara, and every attempt should be made to prevent them.