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Case Report: Bilateral Femoral Neck Fractures in a Child and a Rare Complication of Slipped Capital Epiphysis After Internal Fixation

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Clinical Orthopaedics and Related Research®

Abstract

Background

Bilateral traumatic femoral neck fractures are uncommon in children. The most commonly reported complications are nonunion, avascular necrosis of the femoral head, and chondrolysis. Slipped capital femoral epiphysis (SCFE) associated with nonunion after percutaneous partially threaded cancellous screw (PTCS) fixation of the fracture is an unreported complication.

Case Description

We describe a 10-year-old boy who had bilateral femoral neck fractures secondary to a fall from a height. The patient was treated with percutaneous PTCS fixation on both sides and achieved union on the right side in 3 months, however, a nonunion and SCFE developed on the left side 5 months after the initial surgery. Management of the nonunion and SCFE with PTCS and nonvascularized fibula graft led to union. Eighteen months after the initial injury, the patient achieved a pain and limp-free gait.

Literature Review

A literature review shows avascular necrosis, posttraumatic coxa vara, premature physeal closure, nonunion, chondrolysis, infection, and implant failure as complications of operative management of femoral neck fractures. SCFE has not been previously reported.

Purposes and Clinical Relevance

This case highlights the need for close followup of adolescent patients with PTCS fixation for femoral neck fractures.

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Acknowledgments

We thank the patient’s parents for providing us with informed written consent for publication of this case report.

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Authors and Affiliations

  1. Department of Orthopedics, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India

    Nirmal Raj Gopinathan MS, Dip SICOT, Devendra Chouhan MS, Narendranadh Akkina MS & Prateek Behera MBBS

Authors
  1. Nirmal Raj Gopinathan MS, Dip SICOT
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  2. Devendra Chouhan MS
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  3. Narendranadh Akkina MS
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  4. Prateek Behera MBBS
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Corresponding author

Correspondence to Narendranadh Akkina MS.

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Gopinathan, N.R., Chouhan, D., Akkina, N. et al. Case Report: Bilateral Femoral Neck Fractures in a Child and a Rare Complication of Slipped Capital Epiphysis After Internal Fixation. Clin Orthop Relat Res 470, 2941–2945 (2012). https://doi.org/10.1007/s11999-012-2458-5

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  • DOI: https://doi.org/10.1007/s11999-012-2458-5

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