[Femoral neck fracture in children]

Fractures of the femoral neck in childhood and adolescence are a rare accident injury. Despite their rarity they are significant for the individual child because of the probability of complications, reported in up to 60% of the cases in the literature. They are caused on the one hand by direct damage to the growth joint, which according to recent studies is regarded as a single, continuous, transverse growth plate which includes the trochanteric joint; and on the other by damage resulting from a circulation disorder. Most authors advocate emergency surgical treatment to relieve the hemarthrosis, even though according to the review by Niethard (1982) surgical treatment was not shown to be superior. The patient's age, the localization of the fracture and the extent of dislocation have a major impact on the prognosis. Among the 19 patients treated by the present authors between 1975 and 1989 there were 3 cases of femoral head necrosis in 10 to 15-year-old patients. Seventeen patients underwent surgery. During the same period a number of pathologic fractures of the femoral neck in children were also seen.