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Fractures of the head and neck of the femur in children: an outcome study

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Fractures of the head and neck of the femur in children are very rare, occurring only after a high-velocity trauma, e.g. a fall from a height. This analysis shows the clinical course of traumatic femoral head and neck fractures in paediatric patients. Predisposing factors for poor outcome or fracture complications, such as non-union or femoral head necrosis, are described. Between 1993 and 2006, 16 paediatric patients with proximal femoral fractures were treated at the Level One Trauma Centre of the Medical University of Vienna. The minimum follow-up was two years. Inclusion criteria were age less then 16 years, intact growth plate and a proximal femoral fracture according to the classification by Delbet and Colonna. Exclusion criteria were pathological fractures or fractures of the subtrochanteric region (6/16). Ten patients met the inclusion criteria. Two patients were lost to follow-up. Therefore eight patients were included in the study. All patients except one were operated upon within 48 h after the injury (“primary”) and healed without further complications. A single case was managed by “secondary” surgical treatment, two weeks after the initial trauma resulting in femoral head necrosis that healed without any subjective complaints. This case series confirms the importance of early surgical fixation of proximal femoral fractures in paediatric patients. An operative intervention later then 48 h after the initial trauma may increase the risk of complications such as femoral head necrosis, particularly in Delbet type I fractures (traumatic slipped capital femoral epiphysis).

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  1. Canale ST (1990) Fractures of the hip in children and adolescents. Orthop Clin North Am 21:341–352

    PubMed  CAS  Google Scholar 

  2. Canale ST, Bourland WL (1977) Fracture of the neck and intertrochanteric region of the femur in children. J Bone Joint Surg Am 59:431–443

    PubMed  CAS  Google Scholar 

  3. Ratliff AH (1962) Fractures of the neck of the femur in children. J Bone Joint Surg Br 44-B:528–542

    PubMed  CAS  Google Scholar 

  4. Ratliff AH (1974) Fractures of the neck of the femur in children. Orthop Clin North Am 5:903–924

    PubMed  CAS  Google Scholar 

  5. Kujat R, Suren EG, Rogge D, Tscherne H (1984) Femoral neck fractures during the growth period. Treatment principles, results, prognosis (in German). Chirurg 55:43–48

    PubMed  CAS  Google Scholar 

  6. Hahn MP, Ostermann PA, Richter D, David A (1995) Classification, therapy and complications of pediatric femoral neck fractures (in German). Zentralbl Chir 120:832–840

    PubMed  CAS  Google Scholar 

  7. Davison BL, Weinstein SL (1992) Hip fractures in children: a long-term follow-up study. J Pediatr Orthop 12:355–358

    Article  PubMed  CAS  Google Scholar 

  8. von Laer L (2001) Frakturen und Dislokationen im Wachstumsalter. Thieme, Stuttgart

    Google Scholar 

  9. Delbet MP (1909) Fractures du col de fémur. Bull Mem Soc Chir 35:387–389

    Google Scholar 

  10. Colonna PC (1928) Fracture of the neck of the femur in childhood: a report of six cases. Ann Surg 88:902–907

    Article  PubMed  CAS  Google Scholar 

  11. WK RCA, Beaty JH (1996) Fractures in children. Lippincott-Raven, Philadelphia

    Google Scholar 

  12. Nolan PC, Dilworth R (1996) Irreducible femoral neck fracture in a child. Injury 27:675–676

    Article  PubMed  CAS  Google Scholar 

  13. Hughes LO, Beaty JH (1994) Fractures of the head and neck of the femur in children. J Bone Joint Surg Am 76:283–292

    PubMed  CAS  Google Scholar 

  14. Kay SP, Hall JE (1971) Fracture of the femoral neck in children and its complications. Clin Orthop Relat Res 80:53–71

    Article  PubMed  CAS  Google Scholar 

  15. Nagi ON, Dhillon MS, Gill SS (1992) Fibular osteosynthesis for delayed type II and type III femoral neck fractures in children. J Orthop Trauma 6:306–313

    Article  PubMed  CAS  Google Scholar 

  16. Wiedmann H, Parsch K (1990) Femoral neck fracture in children (in German). Z Orthop Ihre Grenzgeb 128:418–421

    Article  PubMed  CAS  Google Scholar 

  17. Quinlan WR, Brady PG, Regan BF (1980) Fracture of the neck of the femur in childhood. Injury 11:242–247

    Article  PubMed  CAS  Google Scholar 

  18. Ng GP, Cole WG (1996) Effect of early hip decompression on the frequency of avascular necrosis in children with fractures of the neck of the femur. Injury 27:419–421

    Article  PubMed  CAS  Google Scholar 

  19. Rehli V, Slongo T, Gerber C (1993) Fractures near the femur head in children and adolescents (in German). Helv Chir Acta 59:547–552

    PubMed  CAS  Google Scholar 

  20. Leung PC, Lam SF (1986) Long-term follow-up of children with femoral neck fractures. J Bone Joint Surg Br 68:537–540

    PubMed  CAS  Google Scholar 

  21. Hajdu S (1994) Growth disturbances following artificial injury of the growth plate in rabbits. Master Thesis, Department of Trauma Surgery, Medical University of Vienna, Vienna

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Correspondence to Stefan Hajdu.

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Hajdu, S., Oberleitner, G., Schwendenwein, E. et al. Fractures of the head and neck of the femur in children: an outcome study. International Orthopaedics (SICOT) 35, 883–888 (2011).

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