Department of Orthopedic Surgery, Keimyung University, 194 Dondsandong, Joong-gu, Daegu 700-712, Korea.
J Orthop Traumatol. 2013 Jun;14(2):147-54. doi: 10.1007/s10195-012-0188-9. Epub 2012 May 5.
Concomitant ipsilateral fractures of the neck and shaft of the femur in children are rare. The most recent report in this context found a total of only nine reported cases (<12 years of age) following a search of the indexed English literature. These injuries occur in children due to high-velocity trauma, and there is no generally accepted method of treatment. We report three additional cases from the literature and two cases of our own. In our cases, one had a residual 10° varus deformity at the subtrochanteric level in the femur, but this did not affect hip function. Another patient exhibited a limp at final follow-up due to leg length discrepancy, and peroneal nerve palsy at the time of injury. We advocate operative stabilization of the femoral shaft fracture first to reduce the risk of further displacement and simplify the subsequent reduction of the femoral neck. The series shows that these rare injuries have a poor prognosis, with high rates of incidence of avascular necrosis, coxa vara, and leg length discrepancy.
儿童股骨颈干同时骨折较为罕见。最近的相关报道在索引英文文献中仅检索到总共 9 例（<12 岁）。这些损伤是由于高能量创伤导致儿童发生的，目前尚无公认的治疗方法。我们报告了来自文献中的另外 3 例病例和我们自己的 2 例病例。在我们的病例中，1 例股骨转子下水平存在 10°残余内翻畸形，但这并未影响髋关节功能。另一名患者由于下肢长度差异在最终随访时出现跛行，且在受伤时存在腓总神经麻痹。我们主张首先手术固定股骨干骨折，以降低进一步移位的风险并简化随后的股骨颈复位。该系列表明这些罕见的损伤预后较差，发生股骨头缺血性坏死、髋内翻和下肢长度差异的比例较高。
