Femoral neck fracture in children and adolescents

ABSTRACT

Femoral neck fractures in children and adolescents are rare injuries with poor prognosis due to a high rate of complications. During last 10 years, 100 cases of these fractures were seen in children under 17 years of age. Their ages ranged from 3.5 to 16 years [means age 11.43 +/- 3.81]. Sixty one children sustained fracture with severe trauma and thirty nine with moderate to mild trauma. Twenty three fractures were undisplaced while 77 were displaced. Sixty two children underwent internal fixation of fracture fragments while thirty eight were managed conservatively. Overall complication rate was 59% which included avascular necrosis of femoral head [35%], coxa vara [22%], non-union [8%] and premature fusion of capital femoral epiphysis [21%]. Other minor complications were pin tract infection and implant failure. Sixty children had good, 19 fair and 21 poor results [p< 0.001]. The results were poor among 11-13 years age group, in type I fractures and in fractures that were fixed with open reduction. The follow up duration extended from 18 months to 8 years. The aim of this study was to discuss natural history of femoral neck fractures in children, to evaluate different methods of treatment and to highlight difficulties faced during handling these cases thereby helping to evolve a management plan with minimum complications