Functional and radiological results of the surgical treatment of pediatric femoral neck fractures

Abstract

Objective: Our aim in this study was to evaluate the demographic data on femoral neck fractures, postoperative complications, and functional and radiological results following its surgical treatment in the pediatric age group. Pediatric femoral neck fractures often occur after high-energy trauma and seen rarely. Material and Methods: Twenty-six patients who underwent surgery after the diagnosis of femoral neck fracture in our clinic between 2012 and 2019 were examined. Demographic data, trauma mechanism, accompanying injuries, and postoperative complications of the patients were recorded from our registry system. Functional radiological evaluation was performed using Ratliff criteria. Results: The mean age of the participants in the study was 11.11 (3–16) year, and the mean follow-up time was 29.34 (12-60) months. According to Ratliff criteria, 18 patients (69.2%) achieved good, 6 patients achieved (23.1%) moderate, and 2 patients achieved (7.7%) poor results after surgery. Avascular necrosis was observed in 5 patients (19.2%) in total. Avascular necrosis did not occur in 10 patients who underwent surgery within first 6 hours. Avascular necrosis occurred in 5 (31.25%) out of 11 patients who underwent surgery after 6 hours. This result was statistically significant (p = 0.049). Of the 5 patients with avascular necrosis, 3 were female and 2 were male. The clinical and radiological results were evaluated according to the Ratliff criteria, and the results were found to be worse in females than in men. There was a statistically significant difference between the genders (p=0.029). Conclusion: Although femoral neck fractures are rare injuries in the pediatric age group, they are important due to the high risk of complications. The most important complication is avascular necrosis. Results are better males than in females. The results of surgical treatments aimed at anatomical reduction in the shortest possible time are satisfactory