No Negative Influence On Complications of femoral neck fracture Children Age 14-17 years Treatment with Cannulated Screws Transphyseal fixation

Abstract

Abstract Background Hip fractures in children are rare, accounting for less than 1% of all pediatric fractures. The femoral head’s physeal closure at 14 to 17 years of age provides the capacity for spontaneous fracture remodeling. The primary objective of this retrospective study was to determine the impact of transphyseal fixation of cancellous screws on outcomes in this age group. Methods The study included patients aged between 14 to 17 years with Delbet type II and Type III hip fractures treated with cancellous screw fixation from April 2007 to August 2016. Patients were divided into two groups based on whether the cancellous screws threaded across the proximal femur epiphysis: the no cross epiphysis (NCE) group and the cross epiphysis (CE) group. The outcome was an analysis of osteonecrosis of the femoral head, nonunion, delayed union, premature epiphyseal closure (PPC), coxa vara, and overgrowth of the femoral neck. Results Of the 28 patients included in the study, most were male (92.9%). 19 were classified as Delbet type II, and 9 were type III. The CE and the NCE group both included 14 patients. The average follow-up time was 37.8 months (range 26–68 months). The rate of superficial infection, deep infection, AVN, non-union, delay union, coxa vara, PCE, and overgrowth was not significantly different between the two groups. Conclusion In conclusion, the study demonstrated that transphyseal fixation of cannulated screws has no negative impact on outcomes, particularly on femoral head osteonecrosis. Achieving accurate reduction and rigid fixation for this unique injury is more important than preserving the proximal femoral epiphysis.