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.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Injury
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Fractures of the neck of the femur in children.Orthop. Clin. N. Am. 1974; 5: 903-924
- Complications after fractures of the femoral neck in children and their treatment.J. Bone Joint Surg. 1970; 52-B: 175
- Fractures of the head and neck of the femur in children: current concepts review.J. Bone Joint Surg. 1994; 76-A: 283-292
- Types and complications of femoral neck fractures in children.Pediatr. Radiol. 1993; 23: 415-420
- Fractures in children who have Gaucher disease.J. Bone Joint Surg. 1987; 69-A: 1361-1370
- Femoral neck fractures complicating Gaucher disease in children.Skeletal Radiol. 1984; 12: 162-168
- Bilateral femoral neck fractures secondary to hypocalcemic seizures in a skeletally immature patient.Am. J. Orthop. 1999; 28: 187-188
- Fractures of the neck of the femur in children.J. Am. Med. Assn. 1961; 178: 799-801
- Decompression and stable internal fixation of femoral neck fractures in children can affect the outcome.J. Pediatr. Orthop. 1999; 19: 338-343
- Natural healing of hip fractures in childhood.Injury. 1994; 25: 493-496
- Hip fractures in children: a long-term follow-up study.J. Pediatr. Orthop. 1992; 12: 355-358
- Teenage pregnancy: are teenagers a high risk group?.Eur. J. Obstet. Gyn. Rep. Biol. 1995; 59: 17-20
- Fractures of the neck of the femur in children.Am. J. Surg. 1929; 6: 793-797
- Fractures of the neck of the femur in children.J. Bone Joint Surg. 1962; 44-B: 528-542
- The normal vascular anatomy of the human femoral head during growth.J. Bone Joint Surg. 1957; 39-B: 358-394
- The arterial supply of the developing proximal end of the human femur.J. Bone Joint Surg. 1976; 58A: 961-970
- Changing patterns of proximal femoral vascularity.J. Bone Joint Surg. 1974; 56-A: 941-950
- Avascular necrosis complicating undisplaced fractures of the neck of the femur in children.J. Bone Joint Surg. 1959; 41B: 758-762
- Transepiphyseal fractures of the neck of the femur in very young children.J. Pediatr. Orthop. 1992; 12: 164-168
- Effect of early hip decompression on the frequency of avascular necrosis in children with fractures of the neck of the femur.Injury. 1996; 27: 419-421
- Long-term outcome in children with fractures of the proximal femur after high-energy trauma.J. Trauma. 1999; 46: 58-64
- Fractures of the hip in children and adolescents.Orthop. Clin. North. Am. 1990; 21: 341-352
- Fractures of the hip in children: a review of 40 cases.Clin. Orthop. 1980; 149: 177-184
Accepted: November 20, 2001
© 2002 Elsevier Science Ltd. Published by Elsevier Inc. All rights reserved.