Risk factors for avascular necrosis in pediatric femoral neck fractures: a systematic review and meta-analysis
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View abstract on PubMed
Summary
This summary is machine-generated.Older age, fracture type, initial displacement, and poor reduction quality increase avascular necrosis (AVN) risk in pediatric femoral neck fractures (PFNFs). Early reduction and closed reduction with internal fixation (CRIF) may improve outcomes.
Area Of Science
- Orthopedic surgery
- Pediatric orthopedics
- Trauma surgery
Background
- Avascular necrosis (AVN) is a severe complication of pediatric femoral neck fractures (PFNFs).
- Identifying risk factors for AVN is crucial for effective management and follow-up.
- Previous studies have yielded inconsistent findings regarding AVN risk factors.
Purpose Of The Study
- To systematically review and meta-analyze existing literature.
- To identify significant risk factors associated with AVN after PFNFs.
- To provide evidence-based guidance for clinical practice.
Main Methods
- Comprehensive literature search across major databases (PubMed, Web of Science, EMBASE, Cochrane Library) up to April 2025.
- Calculation of risk ratios (RRs) and 95% confidence intervals (CIs) for risk factor associations.
- Performance of sensitivity, meta-regression, and subgroup analyses to explore heterogeneity.
Main Results
- Thirty-four studies involving 1332 pediatric patients were analyzed.
- Older age (≥12 years), Delbet type I/II fractures, initial displacement, and poor reduction quality significantly increased AVN risk.
- Long-term follow-up revealed delayed reduction increased AVN risk, while closed reduction and internal fixation (CRIF) decreased it.
Conclusions
- Older age, Delbet type I/II, initial displacement, and poor reduction quality are key predictors of AVN post-PFNF.
- Timely reduction and CRIF may lead to better long-term outcomes.
- High-quality prospective studies with extended follow-up are warranted.
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