The Operative Treatment on the Fracture of the Displaced Femoral Neck in Children

Song, Kwang Soon; Kang, Chearl Hyoung; Min, Byung Woo; Kim, Young Soo

Abstract

The femoral neck fracture in children are extremely rare and occur secondary to severe trauma. Many authors recommend early anatomical reduction and firm internal fixation because of many complications after treatment. Eleven displaced femoral neck fractures in children who were treated at the Keimyung University Dong San Medical Center from February, 1989 to February, 1993. Following results were obtained, after clinical and radiological evaluations. 1. Fractures of the femoral neck in children occurred from five to sixteen years, the highest inci dence was between ten and thirteen years of age. 2. The main causes of the fracture were traffic accident in 9 cases. 3. 10 cases were treated by arthrotomy, open reduction and internal fixation and one by closed reduction and internal fixation. 4. Operation were performed within 24 hrs after trauma in 5 cases, within 5 days in 4 cases, and 2 cases were performed within 10 days after trauma. 5. According to the classification of Delbet and Colonna(12), cervicotrochanteric fracture(type III) was the most common type(7 cases). 6. The degrees of displacement were 4 cases totally displaced, one case more than two third dis placed, 4 cases 1/3 to 2/3 displaced, and 2 cases less than one third displaced. 7. Complications were transient AVN confirmed by bone scan(1 case) and coxa vara due to nonunion(1 case). 8. According to the Ratliffs assessment(22) the results were good in 9 cases, fair in one, and poor in one.