Treatment of Proximal Femur Fractures in Children

Jung, Sung Taek; Lee, Keun Bae; Yoon, Taek Rim; Moon, Eun Sun; Song, Eun Kyoo

Abstract

To evaluate the pattern of proximal femur fracture in children, the result of treatment, and complications, 30 cases of proximal femur fracture in children aged under sixteen years treated from February 1986 through May 1999 were evaluated. The average follow-up duration was 5.5 years. The type of fractures were classified according to Delbet and Colonna classification, and the results of treatment and complications were analyzed clinically and radiographically. Transcervical type was most predominant. The results of treatment were good in 22 cases, fair in five and poor in three according to Ratliff's assessment. In the groups with fair and poor results, seven cases were displaced fractures. Ten complications were associated with displaced fractures in nine cases; avascular necroses in six cases, premature closure of epiphyseal plate in three, coxa vara in one and malunion in one. Five among six avascular necrosis cases were developed in transcervical fracture, one case was associated with premature closure of epiphyseal plate. Most of the unsatisfactory results with complications in treating proximal fractures in children were found to the associated with displaced fractures. Therefore accurate reduction and internal fixation is mandatory to minimize the complications when fracture were associated with displacement.