Abstract
The Orthopaedics Unit of Aseer Central Hospital, Abha, Saudi Arabia became fully operational
in 1992. From then till 1999, 14 cases of fractures of the neck of femur in children
under the age of 16 years were studied. The aims of the study were to compare our
experience with those of other institutions and to serve as a reference point in this
region for future study of this rare but disabling condition.
The case notes of all the patients aged less than 16 years with fractures of the neck
of femur managed at the Aseer Central Hospital between 1992 and 1999 were analysed
retrospectively. Information obtained included age, sex, type of fracture, management,
outcomes and complications. There were 14 children. The age range between 4 and 16
years (mean = 9.1 ± 3.8 years). Male to female ratio was 1:1.3. Eight cases (57.1%)
were due to road traffic crashes and 6 (42.9%) were due to falls from height. Six
cases (42.9%) were of Delbet type II (transcervical) fractures, 5 cases (35.7%) were
of type III (cervicotrochanteric), and 3 cases (21.4%) were of type IV (intertrochanteric)
fractures. There was no case of Delbet type I (transepiphyseal separation). Patients
were treated either surgically by reduction and internal fixation or conservatively
by traction followed by hip spica cast application. Avascular necrosis occurred in
7 cases (50.0%). Only 3 cases of partial avascular necrosis were seen and all the
3 improved. The rest 4 (28.6%) had collapse of the femoral head. In only 2 cases (14.3%)
of femoral neck fracture, the patients did not have any associated injuries. While
fracture of neck of the femur is rare in children, the high incidence of complications
that can lead to life-long disability makes it an important clinical entity.
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Article info
Publication history
Accepted:
November 20,
2001
Identification
Copyright
© 2002 Elsevier Science Ltd. Published by Elsevier Inc. All rights reserved.