Management of Pediatric Femoral Neck Fracture

Abstract

In the pediatric population, femoral neck fracture is a relatively uncommon injury with a high complication rate, despite appropriate diagnosis and management. The anatomy and blood supply of the proximal femur in the skeletally immature patient differs from that in the adult patient. Generally, these fractures result from high-energy trauma and are categorized using the Delbet classification system. This system both guides management and aids the clinician in determining the risk of osteonecrosis after these fractures. Other complications include physeal arrest, coxa vara, and nonunion. Multiple fracture fixation methods have been used, with the overall goal being anatomic reduction with stable fixation. Insufficiency fractures of the femoral neck, although rare, must also be considered in the differential diagnosis for the pediatric patient presenting with atraumatic hip pain.

Choice of Osteosynthesis in Fractures of the Proximal Femur in Children

“…The main criterion for choosing surgical access and implant was bone anatomy and the presence of active growth zones. [2,4,6]. It is known that at the age of about 4 to 6 years, ossification of the greater trochanter of the femur occurs, almost complete ossification of the femoral head (except its medial surface) and the ossification of the femoral neck ends.…”

“…If surgical treatment of such fractures is necessary, the question arises of choosing a method for fixation of fragments. [2,4,6].…”

No Negative Influence On Complications of femoral neck fracture Children Age Between 14 And 17 Years Treatment with Cannulated Screws Transphyseal fixation

“…Hip fractures represent less than 1% of pediatric fractures [1][2][3][4]. It is usually the result of high-energy injury.…”

“…It is usually the result of high-energy injury. Previous studies have reported a high risk of severe complications following a pediatric hip fracture [1][2][3][4][5][6][7][8]. As a result of anatomical differences, the complications observed in pediatric patients with hip fracture tend to different from those in adults, making this specific patient population and proper surgical management essential to characterize.…”

“…The high rate of complications associated with hip fractures is directly related to its tenuous blood supply. The metaphyseal and epiphyseal blood supplies remain functionally separate until physeal closure at 14 to 17 years of age, and it provides little capacity for spontaneous fracture remodeling [1,9].…”