Surgical treatment of displaced femoral neck fracture in children-a report of 16 cases of three years' fellow-up

Abstract

Objective To evaluate the outcome of decompression and operative fixation for displaced femoral neck fractures in children. Methods From March 2002 to February 2005, sixteen children including 6 females and 10 males with displaced femoral neck fractures underwent operation in our hospital. The average ages at injury were 9.5 years (4 -15 years). The group involved 2 type I fracture, 5 type II and 9 type III fractures, as classified by the Delbet and Colonna system. Mechanisms of injuries were: 3 patients were injured by motorcycle, 8 fell from high places, 2 were injured in snow skiing, and the other 3 suffered injuries due to riding bicycle, car accident and skating respectively. All children underwent early post-injury operation. They were performed with miniarthrotomy, open reduction and internal fixations.Results All patients were followed up for 3 to 7 years after injury, with an average length of 3.6 years. Immediate postoperative radiographs were taken to determine the reduction accuracy. Eight patients had excellent reductions, 5 were good, and 3 were fair. Internal fixations were performed on fourteen patients with compressive screws and 2 patients with K-wires. Follow-up radiographs revealed epiphyseal plate closure in 1 patient, avascular necrosis of the femoral head in 3 patients. Thirteen patients had good hip functions without motion limitation. ConclusionsEarly post-injury decompression of hip by miniarthrotomy and open reduction with internal fixations get good clinical outcomes for displaced femoral neck fractures in children. It decreases the morbidity of post-injury avascular necrosis of the femoral head. Key words: Femoral fractures; Femur head necrosis; Fracture fixation