Department of Orthopaedics, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
Department of Orthopaedics, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
Injury. 2024 Nov;55(11):111829. doi: 10.1016/j.injury.2024.111829. Epub 2024 Aug 22.
To summarize the clinical features of pediatric femoral neck fractures and analyze the risk factors for avascular necrosis of the femoral head.
A retrospective analysis of the case data of pediatric femoral neck fractures treated in our hospital from January 2010 to December 2022, including gender, age, fracture type, causative factors, and surgical details. The occurrence of avascular necrosis of the femoral head was recorded and risk factors were analyzed.
From January 2010 to December 2022, a total of 45 cases of femoral neck fractures were treated in our hospital with a median age at onset of 93 months (IQR=81) and a median time from injury to surgery of 96 hours (IQR=46). Closed reduction was performed in 36 cases, while open reduction was performed in 9 cases. Avascular necrosis of the femoral head occurred in 29 cases postoperatively, while it did not occur in 16 cases. Increased time from injury to surgery and greater degree of fracture displacement were independent risk factors for avascular necrosis of the femoral head. The risk of avascular necrosis in Garden IV type femoral neck fractures was significantly higher than in Garden II and III type patients. An injury-to-surgery time exceeding 82.5 hours was identified as a critical threshold for the development of avascular necrosis of the femoral head.
Pediatric femoral neck fractures have a low incidence rate and are mostly caused by high-energy trauma, often resulting in severe injuries. Therefore, actively maintaining stable vital signs and properly managing associated injuries, timely surgical intervention for femoral neck fractures, achieving good reduction and fixation of displaced fractures are crucial in the treatment of pediatric femoral neck fractures.
总结小儿股骨颈骨折的临床特点，并分析股骨头缺血性坏死的危险因素。
回顾性分析 2010 年 1 月至 2022 年 12 月我院收治的小儿股骨颈骨折患儿的病例资料，包括性别、年龄、骨折类型、致病因素及手术细节等。记录股骨头缺血性坏死的发生情况并分析其危险因素。
2010 年 1 月至 2022 年 12 月我院共收治股骨颈骨折患儿 45 例，发病年龄中位数为 93 个月（IQR=81），从受伤到手术的时间中位数为 96 小时（IQR=46）。36 例行闭合复位，9 例行切开复位。术后发生股骨头缺血性坏死 29 例，未发生 16 例。受伤到手术的时间增加和骨折移位程度增大是股骨头缺血性坏死的独立危险因素。Garden Ⅳ型股骨颈骨折发生股骨头缺血性坏死的风险明显高于 GardenⅡ型和Ⅲ型患者。受伤到手术时间超过 82.5 小时被确定为股骨头缺血性坏死发生的临界阈值。
小儿股骨颈骨折发病率较低，多由高能创伤引起，常导致严重损伤。因此，积极维持生命体征稳定，妥善处理合并伤，及时对股骨颈骨折进行手术干预，实现移位骨折良好复位和固定，对于小儿股骨颈骨折的治疗至关重要。
