Fractures of the femoral neck in adolescence

Zolczer, L; Kazár, G; Manninger, J; Nagy, E

doi:10.1016/s0020-1383(72)80009-3

Cited by 15 publications

(5 citation statements)

References 9 publications

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“…Ratliff et al demonstrated the highest incidence of TFHN occupying the total head (type I), followed by partial necrosis of the epiphysis (type II) and necrosis between the epiphyseal plate and the fracture line (type III) [1]. A high risk of total head necrosis, ranging from 35.7% to 80.7% [1,5,[19][20][21][22], has been con rmed repeatedly by studies on the same subject.…”

Section: Discussionmentioning

confidence: 89%

Pathological progress and prognosis of traumatic femur head necrosis after femoral neck fracture in children and adolescent: a retrospective case series of 64 patients

Yang¹,

Tu²,

Hong³

et al. 2020

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Background: The pathological progression and prognosis of traumatic femur head necrosis (TFHN) after femoral neck fracture (FNF) in children and adolescent is relatively unknown and has never been specifically characterized. As we speculated, the prognosis in such population would be poor and characterized as the high risk of femoral head collapse, hip deformity and degeneration in a short term.Methods: This retrospective case series enrolled 64 children and adolescent with TFHN who treated with observational treatment from 2000.1 to 2018.1. The primary outcomes, such as the progression of femoral head collapse, hip deformity (Stulberg classification) and hip degeneration (Tönnis grade), and their prognostic factors were analysed.Results: 42 males and 22 females with a mean age of 13 years (6-16 years), were included. A total of 28 hips (44%) showed unsatisfactory outcome and Twenty-five (39%) hips collapsed progressively during a mean follow-up of 48 months (24-203 months). Finally, 38 hips (59%) experienced hip deformity, 20 of them were class IV/V. 34 hips (53%) generally progressed to osteoarthritis, 14 of them were classified as grades II/III. The location of the lesion and the presence of lateral subluxation were found to be independently related to progression of femoral head collapse; however, the presence of lateral subluxation was the only independent risk factor of severe hip deformity and degeneration.Conclusion: TFHN in children and adolescent is a rapidly progressing disease with a poor prognosis characterized by a high risk of femoral head collapse progression. If the lateral subluxation emerged, collapsed cases showed increasingly tendency towards severe hip deformity and degeneration.

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Section: Discussionmentioning

confidence: 89%

Pathological progress and prognosis of traumatic femur head necrosis after femoral neck fracture in children and adolescent: a retrospective case series of 64 patients

Yang¹,

Tu²,

Hong³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Ratliff et al demonstrated the highest incidence of TFHN occupying the total head (type I), followed by partial necrosis of the epiphysis (type II) and necrosis between the epiphyseal plate and the fracture line (type III) [1]. A high risk of total head necrosis, ranging from 35.7-80.7% [1,5,[19][20][21][22], has been confirmed repeatedly by studies on the same subject.…”

Section: Femur Head Necrosis In the Paediatric Population Can Be Indumentioning

confidence: 87%

The natural history of traumatic femur head necrosis after femoral neck fracture in children and adolescent: a retrospective case series of 64 patients

Yang

Hong

et al. 2020

Preprint

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Background: The natural history of traumatic femur head necrosis (TFHN) after femoral neck fracture (FNF) in children and adolescent is relatively unknown and has never been specifically characterized. As we speculated, the natural history in such population would be poor and characterized as the high risk of femoral head collapse, hip deformity and degeneration in a short term. Methods: This retrospective case series enrolled 64 children and adolescent with TFHN who treated with observational treatment from 2000.1 to 2018.1. The primary outcomes, such as the progression of femoral head collapse, hip deformity (Stulberg classification) and hip degeneration (Tönnis grade), and their prognostic factors were analysed. Results: 42 males and 22 females with a mean age of 13 years (6-16 years), were included. A total of 28 hips (44%) showed unsatisfactory outcome and Twenty-five (39%) hips collapsed progressively during a mean follow-up of 48 months (24-203 months). Finally, 38 hips (59%) experienced hip deformity, 20 of them were class IV/V. 34 hips (53%) generally progressed to osteoarthritis, 14 of them were classified as grades II/III. The location of the lesion and the presence of lateral subluxation were found to be independently related to progression of femoral head collapse; however, the presence of lateral subluxation was the only independent risk factor of severe hip deformity and degeneration. Conclusion: TFHN in children and adolescent is a rapidly progressing disease with a poor natural history characterized by a high risk of femoral head collapse progression. If the lateral subluxation emerged, collapsed cases showed increasingly tendency towards severe hip deformity and degeneration.

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“…Femoral neck fractures in young adults continue to present an unsolved problem for orthopaedic surgeons due to their high rates of non-union and avascular necrosis [9,14,16]. Similar examples, often associated with delayed presentation of these fractures in developing countries, also tax the ingenuity and imagination of orthopaedic surgeons.…”

Section: Discussionmentioning

confidence: 99%

“…Femoral neck fractures in young adults have always presented a difficult problem with high rates of non-union and avascular necrosis [9,14,16]. In developing countries many of these fractures present late, often as a result of delayed referral or because of initial management by traditional bone-setters.…”

Section: Introductionmentioning

confidence: 99%

Valgus intertrochanteric osteotomy for neglected femoral neck fractures in young adults

Kalra

Anand

2001

International Orthopaedics (SICOT)

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Twenty cases of neglected (more than 1 month old) displaced femoral neck fractures in young adults were treated with a valgus intertrochanteric osteotomy. A fracture union rate of 85% (17 cases) was achieved. Two of the healed cases developed avascular necrosis. After 30 months 15 patients (75%) had achieved good to excellent results. We believe that intertrochanteric osteotomy provides good alternative management for neglected femoral neck fractures.Resumé Vingt cas de fractures du col fémoral déplacées et négligées chez l'adulte jeune ont été traités avec une ostéotomie de valgisation intertrochanterienne. Dix sept fractures ont consolidés. Deux des cas consolidés ont dé-veloppé une nécrose avasculaire. Quinze patients avaient un bon ou excellent résultat avec une moyenne de suivi de trente mois. L'ostéotomie intertrochanterienne est une bonne alternative pour le traitement des fractures du col fémoral négligées.

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Fractures of the femoral neck in adolescence

Cited by 15 publications

References 9 publications

Pathological progress and prognosis of traumatic femur head necrosis after femoral neck fracture in children and adolescent: a retrospective case series of 64 patients

Pathological progress and prognosis of traumatic femur head necrosis after femoral neck fracture in children and adolescent: a retrospective case series of 64 patients

The natural history of traumatic femur head necrosis after femoral neck fracture in children and adolescent: a retrospective case series of 64 patients

Valgus intertrochanteric osteotomy for neglected femoral neck fractures in young adults

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