Management of femoral cervical fractures in children at the Mathlaboul Fawzaini national hospital of Touba: About 16 cases

Abstract

Introduction: Fractures of the femoral neck in children are rare. They are secondary to high kinetic energy trauma and are associated with serious complications. The aim of this study was to report epidemiological, diagnostic, therapeutic and evolutionary aspects of femoral cervical fractures in children. Patients and Methods: This is a retrospective and descriptive study that collected over a period of 5 years, 16 cases of children treated for a femoral neck fracture at the Orthopedic-Traumatology Department of the Mathlaboul Fawzaïni Hospital in Touba from January 1st, 2015 to December 31, 2019. Results: The relative annual frequency was 3.2 cases. The mean age of our patients was 10.9 years and the most represented age group was 10 to 15 years. Our study included 13 boys and 3 girls with a sex ratio of 4.33. Falls from an elevated location and MVAs were the main etiologies. Associated injuries were found in 3 cases. According to Delbet's classification, type III femoral neck fracture was the most frequent with a percentage of 81.2% (13 cases). All our patients had undergone surgical treatment. The approach was closed in 13 cases and open in other cases. The type of osteosynthesis used was screw fixation in 14 cases and a combination of screw and Kirschner wire in 2 cases. According to Ratliff criteria, at the last review (24 months with extremes of 3 and 60 months), we had 13 good results and 3 average results. Three complications on three different patients were found: epiphysiodesis, malunion, and femoral head necrosis. Conclusion: Fractures of the femoral neck in children are rare, especially in children under 10 years of age. Delbet type III is the most frequent injury. Surgical treatment remains the leading indication for the management of these fractures in older children. Treatment results are satisfactory.