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Retrospective analysis of 35 pediatric femoral neck fractures

Abstract

Objective

Pediatric proximal femur fracture is extremely rare trauma comparing to other fractures. The proximal femur fracture is 1% of all pediatric fractures. The aim of current study is to compare the incidence of early complications and outcomes of pediatric proximal femur fractures regarding fracture types retrospectively.

Design

Our study includes 35 cases which are criticized by Delbet classification system, modalities of treatment, duration of waiting for surgery, duration of follow-up and also complications. Our inclusion criteria are age below 16 years old, proximal femur fractures with no evidence of tumoral, romathologic and methabolic conditions. Age, sex and surgery type (open-closed) were noted, and the data were statistically assessed. Assessment of the final outcome was made at the last follow-up visit using the Ratliff’s method.

Results

The mean of age of patients in our study is 9.5 ± 5.06 years. The average follow-up was 25.6 ± 13.2 months. 15 patients (42.9%) are type 2 Delbet fracture, 5 patients (14.2%) are Delbet type 3 and 15 patients (42.9%) are Delbet type 4 fracture. Using the Ratliff’s method, 25 patients (71.4%) had satisfactory outcomes. Ten patients (28.6%) had unsatisfactory outcomes. The complications as AVN, coxa vara and premature closure of physis, non-union and postoperative infections have been detected in this study. AVN was seen in four (11.4%) patients. In addition, coxa vara was seen in six (17.2%) patients.

Conclusion

Pediatric femoral neck fractures are extremely rare fractures and can be treated with low complication rates in cases with early treatment and anatomic reduction.

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Funding

None declared.

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Authors

Contributions

M.Y. designed the protocol, reviewed the literature, analyzed the data, and critically reviewed and wrote the manuscript. O.O. and A.Y. analyzed the data, reviewed the literature, and critically reviewed and wrote the manuscript. T.O.B. and Y.İ. designed the protocol, collected and analyzed the data, and reviewed the literature. M.Ç.K. and S.S.D. collected and analyzed the data. H.G. collected and analyzed the data. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Mustafa Yerli.

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The authors declare that they have no competing interests.

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Yerli, M., Ocak, O., Yüce, A. et al. Retrospective analysis of 35 pediatric femoral neck fractures. Eur J Orthop Surg Traumatol (2021). https://doi.org/10.1007/s00590-021-03126-6

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Keywords

  • Pediatric femoral neck fracture
  • Avascular necrosis
  • Coxa vara
  • Osteonecrosis