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ABSTRACT
| The Outcome of Head-Preserving Screw Fixations of Neglected Femoral Neck Fractures in Children |
| Nuradeen A. Aliyu*, Mukhtar Abdulazeez |
| Introduction: Femoral neck fracture in children is not infrequent; when it occurs, it usually accompanies high-energy trauma and may lead to undesirable complications particularly avascular necrosis (AVN) of the head of the femur and the consequent arthritic changes in the hip. These complications are more likely in the presence of delayed presentation, displaced fracture and more proximal fractures involving the neck of the femur. We aimed to report the outcome of a head-preserving screw fixation procedure for neglected femoral neck fractures in children. Methods: This retrospective study was conducted on twenty-six paediatric patients with neglected femoral neck fractures between February 2016 and March 2022 at Orthopaedic Hospital Wamakko, Sokoto, Nigeria. Patients data was obtained through the previous patients' reords and all the 26 paediatric patients had cancellous screw fixations for the non-united femoral neck fractures. Results: The average age at presentation was 12 years (range 6 to 16 years); there were 18 males and 8 females, and the average presentation time was 7.3 months (range 2 to 18 months). Sixteen affected hips were on the left side, and 10 were on the right. Among the 26 patients in the study, 11(42%) were due to fall from height, 8 (31%) due to road traffic accident (RTA), 5 (19%)) from sports injury, and 2 (8%) from assault/fight. According to Delbet classification, 11 (42%) patients presented with type 2, 9 (35%) patients with type 3, and 6 (23%) patients with type 4 fracture. The mean follow-up of our cases was 2.7 years (range 1.5 to 4.2 years), According to the Ratliff criteria, Fifteen (58%) cases had good results, 7 (27%) with fair results and 4 (15%) with poor results. Among the patients with good results, 3 had a limited range of affected hip joints and occasional mild pains, while the other 4 patients among those with fair results had early AVN with limited function. All 4 patients with poor results had developed some degree of AVN with evidence of early osteoarthritic changes. Conclusion: Paediatric femoral neck fractures have potential complications, particularly among those patients with delayed presentation. A head-preserving screw fixation in these cases could offer a good treatment alternative to buy more time for the advanced hip replacement in children where hip prostheses may be difficult to secure in developing countries. |
| 10.51658/ABMS.202441.8 |
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