Functional results after surgical treatment of pediatric femoral neck fractures

Abstract

This study aims to present the functional outcomes of patients who were treated surgically for childhood femoral neck fractures. In addition, to obtain information about the complications seen after these fractures, especially avascular necrosis of the femoral head (AVN), and to investigate the relationship with the treatment process. Our study is a retrospective study including 22 fractures of 22 patients operated for femoral neck fractures between 2012 and 2021. Thirteen of the patients were boys and 9 were girls The mean age at the time of trauma was 12.6 years (5-17 years). The fractures were classified based on the Delbet/Colonna classification. Fracture type and its effect on functional outcomes and the effect of fracture type on complications were investigated. The relationship between the time and type of treatment and AVN was evaluated. The mean follow-up period of the patients included in the study was 36.9 (12-132 months) months. Orthopedic injury in combination with femoral neck fracture was seen in 4 patients. Femoral neck fractures were classified as type 1 in 1 patient, type 2 in 15 patients, type 3 in 4 patients, and type 4 in 2 patients. In our study, 5 of 8 complications were AVN. The clinical results of the patients were classified with Ratliff score and 14 patients had good, 3 patients had fair and 5 patients had poor results. According to this classification system, 5 patients who developed AVN had a poor outcome, but no significant correlation was found between AVN and the timing of surgery and treatment method. All of the cases with AVN were Type 1 and Type 2 fractures. Pediatric femoral neck fractures are inherently difficult fractures for orthopedists who need long-term follow-up. Although the appropriate time, methods, and materials for surgical management are frequently discussed, the severity of the injury and the anatomical location of the fracture is most important in the development of AVN.