Femoral Neck Fractures in Children: A Follow-Up Study of 19 Cases.

We studied 20 fractures of the neck of femur in 19 patients under the age of 16 years that were treated in the period from 1998 to 2004. There were nine boys and ten girls with an average age of 11 years. There was one case of Delbet type I (transepiphyseal separation). Thirteen cases were of Delbet type II (transcervical) fractures, four cases were of type III (cervicotrochanteric), and two patients had old fractures (one Delbet type II and one type III). Fourteen fractures were displaced. In our study group, 11 patients were treated surgically by internal fixation while the remaining were treated conservatively by traction followed by hip spica cast application. Mean follow-up was 24 months (range 1-5 years). Avascular necrosis occurred in nine cases (45%). Other complications included coxa vara in two, nonunion in two, postoperative infection in one, and refracture in one. The amount of displacement of the fracture and the quality of reduction and fixation influenced the occurrence of complications such as avascular necrosis and nonunion.