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Year : 2018  |  Volume : 15  |  Issue : 2  |  Page : 114-117

Management of femoral neck fractures in children: Experience of a short series in a developing country

Department of Mother and Children, University of Félix Houphouet Boigny Pediatric Surgery Unit, CHU Yopougon, Côte d'Ivoire, Abidjan, Côte d'Ivoire

Correspondence Address:
Pr. Jean Baptiste Yaokreh
Department of General Pediatric Surgery, CHU Yopougon, University of Félix Houphouët Boigny, Abidjan Cote d'Ivoire, 21 BP 2954
Côte d'Ivoire
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ajps.AJPS_93_17

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Background: Fractures of the femoral neck are rare injuries in children but can have many devastating complications. Their treatment is not standardized, but the objectives are early anatomic reduction to minimize the risk for complications. The aim of this study was to assess outcomes of a short series of femoral neck fractures managed in a resource-limited setting. Materials and Methods: The medical charts of 11 children who were managed in our institution for femoral neck fractures between January 2000 and December 2015 were assessed retrospectively. There were two cases (n = 2) of Delbet type I, 5 (n = 5) type II, and 4 (n = 4) type III fractures. Patients were treated either surgically by open reduction and internal fixation (n = 4) or conservatively by traction followed by spica cast (n = 7). Outcomes were assessed using Ratliff system. Results: Femoral neck fracture incidence was one case per year. Of the 11 patients, there were 7 boys and 4 girls, with a mean age 9.4 ± 3.28 years. At the mean follow-up of 3.64 ± 1.97 years (range, 2–8.8 years), outcome was fair to good in 8 (72.7%) and poor in 3 (27.3%) cases. Average union time was 13.5 ± 1.77 weeks. Complication rate was 72.7%. Avascular necrosis occurred in three cases (27.3%). Six patients (54.5%) developed coxa vara, with a mean neck-shaft angle of 102.16° ±12.07° (range, 90°–118°). Five patients (45.5%) had leg length discrepancy with a mean 18 mm (range, 7–35 mm). Discussion: local conditions negatively influenced the management of femoral neck fractures. Conservative treatment led to many complications which increase the cost of management.

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