Results of treatment of children with femoral neck fractures

Abstract

Introduction. Femoral fractures in children remain a topical problem because of the risk and frequency of severe complications, such as aseptic necrosis of the femoral head that causes deforming coxarthrosis and early disabilities. This type of injury accounts for approximately 1% of all skeletal bone fractures in childhood. In 80% of the cases, the cause of femoral neck fracture is severe trauma, but in 15% of patients, the fracture occurs despite inadequate trauma during physiologically normal activity of the child. With femoral neck fractures without stable osteosynthesis, consolidation of bone fragments occurs extremely rarely, and a long period of immobilization during conservative treatment is accompanied by a risk of complications caused by hypodynamia.
 Aim. To conduct a retrospective analysis of the results of surgical treatment of different types of fracture of the femoral neck in children.
 Materials and methods. We analyzed surgical treatment results of 5 children aged 10 to 17 years (4 boys, 1 girl) with different types of femoral neck fractures according to the Delbet and Colonna classification. The cause of the fractures in all 5 children was high-energy trauma. All patients, depending on the type of fracture, underwent a closed repositioning with osteosynthesis of the fragments using metal constructions (cannulated screws, DHS plate). Follow-up observations were performed ≤7 years after the surgical treatment.
 Results. Restoration of the hip joint function, absence of pain syndrome, absence of complications, and complete social adaptation was achieved in all cases.
 Conclusion. Femoral neck fractures are subject to immediate surgical treatment because there is a high risk of aseptic necrosis of the head of the femur. With the correct technical performance, it is possible to achieve stable, positive, functional, and radiologic long-term results.