आघात एवं उपचार जर्नल

Is Urgent Treatment of Pediatric Neck Femur Always Needed?

Abstract

Shamim Ahmad Bhat, Khurshid Ahmad Kangoo, Asif Nazir Baba, Adnan Zahoor and Sami Jan

Purpose: Pediatric hip fractures are very uncommon and the complications of these fractures are very serious. With this purpose in mind we evaluated retrospectively the treatment of pediatric femur neck fractures admitted during proceeding five years in our hospital. The Aim of study was to evaluate the outcome of our treatment and know preventable complications of pediatric neck fractures in comparison with literature. Method: We evaluated 19 pediatric femur neck fractures with age from 3-12 years including 12 males 7 females. Treatment was by closed reduction and internal fixation at average of 4.5 days after hospital admission. Spica cast was applied for all patients up to age 10. Clinical and radiological evaluation was done by RATLIFF CRITERIA Results: We enrolled 23 cases in study 4 lost to follow up and thus excluded from final study. We had 10 cases of Delbet type II, 7 cases type III and 2 cases of type IV. Patients were treated by closed reduction and internal fixation at average of 4.5 days after admission. Our results were 12 good, 3 fair and 4 poor. Complications encountered included avascular necrosis in 5 patients, 1 coxa vara, 2 cases of superficial infection and 1 septic sequel of sab acute septic arthritis. Conclusion: Fluoroscopic aided reduction and internal fixation is a very good method of treatment for pediatric neck femur fractures. Emphasis should be on measures to reduce avascular necrosis and infection and give maximum smile to the children and their parents. In our under eloped and far-flung area complications are unavoidable but preventable once infrastructure and facilities of emergency and postoperative care are improved. Education regarding prevention of pediatric fractures in general and neck femur in particular and active participation of parents will help in minimizing complication of these fracture thus limiting diability and morbidity of these fractures.