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TRAUMATOLOGY
Year : 2006  |  Volume : 40  |  Issue : 4  |  Page : 228-231

Unstable femoral neck fractures in children - A new treatment option


1 Department of Orthopaedics, SN Medical College, Agra, India
2 Department of Orthopaedics, Maulana Azad Medical College, New Delhi, India

Correspondence Address:
K K Pruthi
Department of Orthopaedics, SN Medical College, Agra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5413.34500

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Background : Femoral neck fractures in children are an uncommon but difficult situation. The aim of our study was to evaluate clinical results of closed reduction internal fixation and primary valgus osteotomy fixed with a tension band wire loop in high angled pediatric femoral neck fractures. Methods : In a prospective nonrandomized study conducted at 2 centres, sixteen children and adolescents with a Pauwel type 2/3 fracture neck femur were taken as participants. The femoral neck fractures were stabilized using closed reduction and internal fixation (6.5 mm noncannulated screw) and a primary valgus osteotomy fixed with a tension band wire loop preferably within 24-36 hours of injury. Patients were evaluated to determine complications, clinical and radiological outcome. Results : At a mean post operative follow up of 5 years, union was achieved in all cases. Three patients had AVN and one developed coxavara. Results were evaluated using IOWA hip scores. Thirteen patients had an excellent result while 3 patients had a good result. Conclusion : Use of this technique holds promise in treating these difficult unstable fractures. Although results from a larger series are still awaited yet the use of this technique can safely be extended to stable fractures also, to minimize the incidence of complications as nonunion and AVN.


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