Naik Premal, Mantri Nihit, Tank Parag, Bhesaniya Ravi
Rainbow Super-Speciality Hospital, Children's Orthopaedic Centre, Next to Asia School, Behind HDFC Bank, Opposite Drive In Cinema, Bodakdev, Ahmedabad, Gujarat 380 054 India.
Honorary Pediatric Orthopedic Surgeon, Smt SCL Hospital, NHL Municipal Medical College, Ahmedabad, Gujarat India.
Indian J Orthop. 2021 Mar 18;55(Suppl 2):501-507. doi: 10.1007/s43465-021-00388-4. eCollection 2021 Jul.
A bilateral neck of femur fracture in children is a rare occurrence with only twelve cases reported till the date. We report a case of a 3-year-old schoolgirl with bilateral Delbet type 2 fracture neck femur after a fall from height. She was managed elsewhere by bilateral closed reduction and screw fixation within 24 h. She presented to us three months after surgery with painful hip movements and inability to walk. Her X-ray showed bilateral Ratliff type three avascular necrosis and bilateral delayed union with visible fracture lines. We placed her in double hip spica for three months. Fortunately, on both sides fractures united well with complete resolution of avascular changes. At one year follow-up, she had no functional limitation, no limb length discrepancy, and an x-ray showed mild coxa vara on left. Bilateral delayed union and avascular necrosis of fracture neck femur has not been reported till date.
儿童双侧股骨颈骨折较为罕见，迄今为止仅报道过12例。我们报告一例3岁女童，从高处坠落致双侧Delbet 2型股骨颈骨折。她在别处接受了双侧闭合复位及螺钉固定治疗，于伤后24小时内完成手术。术后三个月，她因髋关节活动疼痛及无法行走前来我院就诊。X线显示双侧Ratliff 3型股骨头缺血性坏死及双侧骨折延迟愈合，骨折线清晰可见。我们让她佩戴双髋人字石膏固定三个月。幸运的是，双侧骨折均顺利愈合，股骨头缺血性改变完全消失。随访一年时，她没有功能受限，双下肢无长度差异，X线显示左侧有轻度髋内翻。双侧股骨颈骨折延迟愈合及股骨头缺血性坏死迄今为止尚未见报道。
