Complications of Pediatric Femoral Neck Fractures

Abstract

Background and Objectives: Pediatric femoral neck fracture is a rare condition leads to <1% of all fractures in children which is associated with high rates of complications. At present study, we performed a long-term follow-up of 37 patients and analyzed the complications. Materials and Methods: This descriptive study contained 37 children (24 boys and 13 girls) who sustained femoral neck fractures. The patients were treated conservatively management or by internal fixation through closed or open means. The clinical and radiological outcomes were analyzed using Ratliff criteria. Results: The mean age of patients was 11.1±3.4 years that completed an average follow-up of 3.14 years. The most common etiological factor was traffic accident. A satisfactory outcome according to Ratliff’s radiological and clinical criteria was obtained in 27 (73%) hips. Based on Delbet’s classification system, there were 2 type I (5.4%), 18 type II (48.6%), 11 type III (29.7%), and 6 type IV (16.3%) fractures. Avascular necrosis (AVN) was the most common complication that was seen in 8 of our patients. Other complications included 4 cases of coxa vara, 3 nonunion cases, one case of infection, 2 cases each of arthritic changes and premature epiphyseal closure. Conclusion: Despite of this fact that the fractures of pediatric femoral neck are very rare, incidence of complications is high which could lead to the long morbidities.

Keywords: Pediatric Femoral Neck Fracture, Avascular Necrosis, Hip, Fracture Complication