Nonunion of fractures of the femoral neck in children

Abstract

The authors present the prospective clinical outcome of nine pseudoarthroses resulting from surgical treatment carried out in nine children, whose ages varied from 6 years and 2 months to 14 years and 2 months (mean 10 years and 2 months), who had fractures of the femoral neck. Five were classified as type II, according to the Delbet classification modified by Colonna, and four were type III. The initial fractures were caused by highenergy traumas, such as trampling, bicycle falls, and car accidents. Treatment of choice was valgus osteotomy of the femoral neck associated or not with insertion of bony graft. The mean time of follow-up was 38 months, ranging from 23 to 71 months, and the mean time of pseudoarthrosis consolidation after osteotomy was 76.6 days, varying from 45 to 240 days. In this study, all the pseudoarthroses consolidated. For final analysis of clinical and radiographic results, the Ratliff's classification was used. We obtained three cases as good results, five as fair and one as poor. The authors concluded that valgus osteotomy is a good option for treatment of pseudoarthrosis in the femoral neck fractures in children.

Closed Reduction And Cannulated Screw Fixation For Pediatric Femoral Neck Fractures: A Case Series

“…Fracture fixation techniques with low maintainability such as immobilization with a plaster cast, Kirsher wires or fixation with threaded pins are considered to be important risk factors for nonunion. (23,24) In different studies, the incidence of coxa vara after PFNFs has been reported in the range of 7-32%. (14,16,25) The incidence of coxa vara in our cases (16.7%) is consistent with the literature.…”

Technology of percutaneous cannulated screw implantation using screw view model of navigation in Garden type I of femoral neck fracture

“…Accordingly, complications (e.g., multiple drills, increased fluoroscopy time, uneven screw distribution, head perforation, and failure of internal fixation) may occur during the operation. [3–5,10,12–14] Accordingly, appropriate placement of guide needles is vital to treat FNF with PCS. [17] The use of a SVMN technique was explored to assist in a PCS insertion.…”

Non-union fracture neck femur in a toddler: Reconstructed by valgus osteotomy – A minimally invasive approach

“…In a series of nine cases done by Pedro et al, they have achieved 100% union rate of their cases done by intertrochanteric valgus osteotomy and plate fixation; they reported only one case of delayed union but it eventually healed. 5 In our case, we have used a K-wire and two non-cannulated cancellous screws. Non-cannulated screws were intentionally used because they are economical and probably exert more compression at the fracture site than a cannulated one.…”