CLASSIFICATION, MANAGEMENT AND COMPLICATIONS OF FEMORAL-NECK FRACTURES IN CHILDREN

Femoral neck fractures in children are rare injuries (less than 1 percent). The fracture pattern consists of transepiphyseal, transcervical, cervicotrochanteric and intertrochanteric fractures. Main problems with this type of injury are avascular necrosis, varus deformity, nonunion and premature epiphyseal closure. Varus and nonunion are affected by the treatment, vascular compromise with necrosis or growth problems are not related to therapy and hardly to control. Primary dislocated fractures are emergencies and need immediate operative management. Stabilization Is achieved with K-wires or cancellous screws dependent on the child's age. In children below 3 years a pelvis cast is necessary postoperatively. Partial weight bearing is started 6 weeks post trauma and is rapidly increased to full weight bearing. One year post-operation the metal is removed, K-wires directely after bony healing.