Morphological characteristics analysis of femoral neck fracture in children

Abstract

Purpose To investigate the morphological characteristics of pediatric femoral neck fracture (FNF) from clinical cases by fracture mapping technology and to analyze the relationship between fracture classifications and age. Methods The CT data were collected from 46 consecutive pediatric inpatients diagnosis of FNF from March 2009 to December 2022. The fracture imaging were reconstructed in three dimensions and performed simulated anatomical reduction by Mimics and 3-matic. Both Delbet classification and Pauwels angle classification were documented according to the fracture line in each patient. Furthermore, all of the fracture lines in these patients were superimposed to form a fracture map and a heat map. Results This study included 24 boys and 22 girls (average age, 9.61 ± 3.17 years (4 to 16 years)). The fracture lines of anterior and superior femoral neck were found to be mainly located in the middle and lower regions of the femoral neck, while fracture lines of posterior and inferior neck were mainly concentrated in the middle region. Most children younger than 10 years had Delbet Ⅲ type of fracture (69%), whereas those older than 10 years had Delbet Ⅱ type of fracture (73%). Furthermore, most children had Pauwels angle III type of fracture (63%), especially in those over 10 years old (80%) (p < 0.05). Conclusion FNF in children are predominantly located in the middle and lower regions of the neck. Older children may be prone to be affected with higher fracture location of FNF or unstable type of fracture.