Treatment of Fractures of the Femur Neck in Children / 대한정형외과학회잡지

ABSTRACT

We have treated total 37 cases of femoral neck fracture in children who were under the 16 years old in age at the Catholic University Medical College since 1985, followed them for average 21 months to analyse their types of fracture and treatment, complications and prevention of complications, and obtained the following results. 1. According to the Delbet's classification, type I was 1 case, II were 18(49%), most common, III were 10 and IV were 8 cases. Their ages were average 8.2 years and boys were predominant in 27 cases. 2. Thirty-six cases were treated with open reduction and internal fixation within 1-13 days after fracture, but only one type IV was treated with closed reduction, followed by hip spica cast for 6 to 9 weeks in all. 3. The fixation devises were removed at average 8.7 months after operatio. 4. fifteen complications were observed in 11 cases(37%), that were AVN(3 cases), early physeal closure(8 cases), coxa vara(3 cases), coxa valga and limb shortening(each 1 case), and their causes were severe fracture displacement(2 cases), penetration of fixation devices to physis(8 cases), incomplete reduction and loss of initial reductio (1 case) etc, but were not correlated with their method of fracture treatment. Conclusively, the femur neck fracture in children could favorably be treated with open reduction and internal fixation to reduce their complications. Physeal early closures due to penetration of screws and pin were most common cause of complications, and their long-term follow-up should be necessary.