[Dislocated basicervical fracture of the femoral neck in a 7-year-old girl].
This report discusses the treatment of a seven-year-old girl with a displaced fracture of the proximal femur (AO 32-M / 3.1 II, Delbet type III) after falling 4 m from a tree. She was treated by immediate (within 6 h after trauma) open reduction and capsular decompression. The fracture was stabilised with 2 cannulated titanium screws that did not go beyond the epiphyseal cartilage. Clinical and radiological examination after 2 years showed no complications, especially no sign of avascular necrosis (AVN) of the femoral head. The functional outcome with Ratliff's classification was good. In accordance with the latest literature, we recommend immediate open reduction with accurate reposition, capsular decompression, and stabile internal fixation in order to treat dislocated complete basicervical fractures. This combination minimises the devastating complications of AVN for these fractures and various other complications including malunion, non-union, leg-length discrepancy, premature epiphyseal closure, coxa vara and valga.
Kolibay-Knief
J
J
Evangelisches Krankenhaus Düsseldorf, Abteilung für Orthopädie und Unfallchirurgie, Sporttraumatologie, Düsseldorf, Deutschland. julia-knief@t-online.de
v Kroge
H
H
D001863:Bone Screws; D002648:Child; D005260:Female; D005265:Femoral Neck Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005271:Femur Head Necrosis / Q000517:prevention & control; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000517:prevention & control; D011859:Radiography