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Review Article
Pediatric Femoral Neck Fracture
Joo Hyung Han, Hoon Park
J Korean Fract Soc 2021;34(1):34-43.   Published online January 31, 2021
DOI: https://doi.org/10.12671/jkfs.2021.34.1.34
AbstractAbstract PDF
Pediatric femoral neck fracture is an uncommon injury with a high complication rate, regardless of the appropriate diagnosis and management. The bony anatomy and blood supply of the proximal femur in a skeletally immature patient differ from those in adult patients. Generally, these fractures result from high-energy trauma, but pathologic hip fractures also occur, usually from low-energy trauma. Pediatric femoral neck fractures are categorized using the Delbet classification system. This classification guides management and aids clinicians in determining the risk of avascular osteonecrosis. The ideal surgical treatment is determined by the fracture type and the age of the patient. Reduction, which is achieved using a closed or open procedure, combined with stable fixation and/or cast immobilization, is recommended for most of these fractures. Anatomical reduction within 24 hours from the injury may result in a good surgical outcome. Although the effects of capsular decompression after reduction and fixation have not been established, decompression is easy to perform and may reduce the risk of avascular necrosis. Despite appropriate management, osteonecrosis can occur after all types of pediatric femur neck fractures. Other complications include coxa vara, nonunion, and premature physeal arrest.
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Original Articles
Complications and Affecting Factors for Intracapsular Femoral Neck Fractures Treated by Multiple Pinning
Sung Jung Kim, Shin Yoon Kim, Gi Bong Cha, Chang Wug Oh, Il Hyung Park, Joo Chul Ihn
J Korean Soc Fract 2002;15(2):201-208.   Published online April 30, 2002
DOI: https://doi.org/10.12671/jksf.2002.15.2.201
AbstractAbstract PDF
PURPOSE
To investigate the relationship between the complications of intracapsular femoral neck fractures treated by multiple pinning and several affecting factors.
MATERIALS AND METHODS
Sixty-eight patients with intracapsular femoral neck fractures were treated by multiple pinning from March 1993 to January 2000 and followed at more than one year. Relationship between the complications such as failure of union, collapse of femoral head due to osteonecrosis of femoral head and several affecting factors including displacement of fracture according to Garden stage, state of reduction, position of screws, time interval from injury to operation, and fracture level were analyzed. The Fisher exact test, chi-square test, and multivariate logistic regression analysis were used to find the relevant factors influencing incidence of complications. Statistical significance was set at p < 0.05.
RESULTS
Position of screw was the most important single factor affecting the results of treatment of intracapsular femoral neck fracture (p=0.046). Moreover, the Garden stage and position of screw were revealed affecting the incidence of complications together with other factors (each p value was 0.028 and 0.027).
CONCLUSION
We considered that satisfactory position of screw was important to reduce complications after multiple pinning for intracapsular femoral neck fracture. And the results of operation also seemed to closely relate with multiple factors including Garden stage and status of reduction.

Citations

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  • Factors Predicting Complications after Internal Fixation of Femoral Neck Fractures
    Tae-Ho Kim, Jong-Oh Kim, Sung-Sik Kang
    Journal of the Korean Fracture Society.2009; 22(2): 79.     CrossRef
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Treatment of Femoral Neck Fractures in the Elderly Patiene
Chung Nam Kang, Kwon Jae Roh, Yeo Hon Yun, Dong Jun Kim, Cheol Min Kim
J Korean Soc Fract 1995;8(1):61-67.   Published online January 31, 1995
DOI: https://doi.org/10.12671/jksf.1995.8.1.61
AbstractAbstract PDF
We analyzed 41 femoral neck fractures in 40 elderly patients aged over 65 years. All of them were treated by surgery and followed for average 22 months (range, 14 to 52 months) at the Ewha Womans University Hospital from 1988 to 1992. Of these, 15 cases were treated with internal fixation and 26 cases with endoprosthetic or total hip replacement arthroplasty For the level of fractures the most common features were subcapital, that were moderately to severely (Gardens stage III or IV) displaced. In the internal fuation group the results were unsatisfactory in the cases of subcapital type, moderate to severe (Gardens stage III or IV) displacement, Pauwels type III and those with osteoporosis (below stage III in Singh index). Our short term follow-up results showed that the prosthetic replacement group were generally superior in that they were not affected by the types of fractures and the degree of osteoporosis.
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