Clinical features and surgical outcomes of greater trochanteric fractures of the femoral neck in children
10.3760/cma.j.cn115530-20230914-00107
- VernacularTitle:儿童股骨颈合并大转子骨折的临床特点及手术疗效分析
- Author:
Yuancheng PAN
1
;
Tianlai CHEN
;
Chentao XUE
;
Fengshan LU
;
Zhibin OUYANG
;
Yueming GUO
;
Shunyou CHEN
Author Information
1. 福州市第二总医院小儿骨科，福建省创伤骨科急救与康复临床医学研究中心，福州 350007
- Keywords:
Femoral neck fractures;
Hip fractures;
Fracture fixation, internal;
Bone nails;
Bone plates;
Child
- From:
Chinese Journal of Orthopaedic Trauma
2024;26(6):538-542
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical features and surgical outcomes of greater trochanteric fractures of the femoral neck in children.Methods:A retrospective study was conducted to analyze the 5 children with greater trochanteric fracture of the femoral neck who had been treated at Department of Pediatric Orthopaedics, Fuzhou Second General Hospital from January 2011 to December 2020. There were 1 boy and 4 girls, with an age of (11.0±1.9) years. By the Delbet classification, all were type Ⅲ fractures. The time from injury to operation was (4.4±2.1) days. The children were treated with cannulated screws (1 case) or fixation with a pediatric hip plate (4 cases). The clinical features of such fractures were analyzed; the fracture union time and hip function and complications at the last follow-up were recorded.Results:The clinical features of greater trochanteric fractures of the femoral neck in children were: (1) involvement of 2 anatomic sites in a narrow region, (2) comminuted fractures, and (3) all Delbet type Ⅲ fractures. The follow-up time was (22.8±6.0) months. All the 5 children obtained bony union. The union time was (5.2±1.8) weeks for greater trochanteric fractures, and 8.0 (8.0,10.0) weeks for femoral neck fractures. Follow-up observed no necrosis of the femoral head, premature closure of the femoral head epiphysis, hip varus deformity, or length disparity between the lower limbs. Premature closure of the greater trochanteric epiphysis occurred in 2 children after surgery. According to the Ratliff scoring, the hip function was excellent in 3 cases and good in 2.Conclusions:Greater trochanteric fractures of the femoral neck in children are a special kind of proximal femoral comminuted fractures that affect 2 anatomic sites in a narrow region and belong all to Delbet type Ⅲ fractures. Open reduction and internal fixation with cannulated screws or a pediatric hip plate is a safe and effective treatment for such fractures.
