Ipsilateral femoral neck and shaft fracture in children: Two case reports.

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Tytuł:: Ipsilateral femoral neck and shaft fracture in children: Two case reports.
Autorzy:: Xing H; Department of Orthopaedic Surgery, Lishui Hospital, Zhejiang University School of Medicine, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central Hospital, Lishui, Zhejiang, People's Republic of China.
Wu Q
Lan S
Wang C
Ye J
Ye F
Huang S
Źródło:: Medicine [Medicine (Baltimore)] 2021 Jan 29; Vol. 100 (4), pp. e23616.
Typ publikacji:: Case Reports; Journal Article
Język:: English
Imprint Name(s):: Original Publication: Hagerstown, Md : Lippincott Williams & Wilkins
MeSH Terms:: Femoral Fractures/*surgery
Femoral Neck Fractures/*surgery
Femur Neck/*injuries
Fracture Fixation, Intramedullary/*methods
Bone Nails ; Bone Plates ; Bone Screws ; Child ; Child, Preschool ; Femur Neck/surgery ; Humans ; Male
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Song KS, Ramnani K, Cho CH, et al. Ipsilateral femoral neck and shaft fracture in children: a report of two cases and a literature review. J Orthop Traumatol 2013;14:147–54.
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Entry Date(s):: Date Created: 20210203 Date Completed: 20210208 Latest Revision: 20230103
Update Code:: 20240104
PubMed Central ID:: PMC7850742
DOI:: 10.1097/MD.0000000000023616
PMID:: 33530163
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Rationale: Pediatric femoral shaft combined with ipsilateral femoral neck fractures are very rare but challenging injuries fraught with the development of avascular necrosis, coxa vara, and leg length discrepancy. Majority of the previous reports indicated the neck femur fracture was fixed with cannulated screws or/and pins, femoral shaft fracture was stabilized with a plate and screws. However, we used cannulated screws combined with elastic stable intramedullary nails to minimally invasive procedures treat this type of injury and achieved good follow-up results.
Patient Concerns: A 7-year-old boy (Case 1) was hospitalized due to a traffic accident resulting in swelling and deformity of the right thigh accompanied by limited mobility of hip and knee. A 5-year-old male child (Case 2) presented with pain and swelling in the bilateral lower limb after fall from approximately 12 feet.
Diagnoses: Physical examination, X-ray film, and computed tomography were performed. Both patients were diagnosed with ipsilateral femoral neck and shaft fracture.
Interventions: The fractures were reduced closed by image-intensifier imaging. Two partially threaded cancellous screws were used to fix femoral neck fracture, and elastic intramedullary nails were performed to stable the femoral shaft fracture. Postoperatively, the patients were immobilized in a one-and-a-half hip spica cast for six weeks. The internal fixations were removed after one year.
Outcomes: Case one was follow-up at 14 months and the other one was followed up for 3 years. And at the last follow-up showed a normal and painless hip function. No clinical complications were found during follow-up visit, including head penetration, implant failure, fracture nonunion, avascular necrosis and hip varus deformity.
Lessons: Clinician should carefully check and read relevant imaging data to avoid missed diagnosis. And the internal fixation method described in this paper may be more minimally invasive.
Competing Interests: The authors declare that they have no conflict of interest.
(Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

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