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Femoral neck fractures in children and adolescents


Authors: Marcel Guřan;  Stanislav Čambor;  Miroslav Lisý;  Ladislav Plánka;  Petr Gál
Authors‘ workplace: Clinic of Pediatric Surgery, Orthopedics and Traumatology, the Faculty Hospital Brno, Czech Republic ;  Klinika dětské chirurgie, ortopedie a traumatologie FN Brno ;  Department of Traumatology, Tomas Baťa Regional Hospital Zlín, Czech Republic ;  Traumatologické oddělení Krajské nemocnice Tomáše Bati Zlín
Published in: Úraz chir. 17., 2009, č.2

Overview

Objective:
Our study presents treatment results of proximal femoral fractures dealt with at KDCHOT FN Brno and KNTB over a period of 12 years (1997–2008). We focused on the therapy results and the development of postoperative complications in particular. The final outcome of our study is based on examination of the selected procedure in terms of its standard application in this type of injury. The standard procedure is considered helpful in case of diagnostic and therapeutic doubt resulting from low incidence.

Materials and methods:
The primary sources included information on injury mechanism and first treatment. In addition to the selected procedure, the interval between injury and first treatment was considered. In the next stage, we monitored clinical treatment results (range of hip joint movement, patient’s own assessment), X-ray examination results and the occurrence of complications. Our aim was to provide an over-view of the applied methods and their therapeutic results and also to find a statistically significant relation between the incidence of avascular necrosis and the time of first treatment, the injury type based on the Delbet-Collona classification and the patient age.

Results:
A statistically significant relation of the interval between injury and first treatment to the incidence of avascular necrosis was proved. Avascular necrosis was found to develop in patients with surgical treatment 14 and more hours after injury. A statistically significant relation was also established between the injury type based on the Delbet-Collona classification and avascular necrosis incidence. Necrosis did not occur in type IV and the highest incidence was found in type II. A statistically significant relation between necrosis incidence and the patient age was not proved in our data set.

Conclusion:
Out of the total of 48 patients, 73 % exhibited healing without subsequent complications. On the whole, avascular necrosis incidence was low (16%) and so was the occurrence of coxa vara (13%). The occurrence of other complications was rather scarce.

Key wordsp:
pproximal femur, avascular necrosis, child, osteosynthesis.


Sources

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Labels
Surgery Traumatology Trauma surgery
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