Jiang Yikun, Wang Yanbing, Peng Chuangang, Yuan Baoming, Wu Dankai
Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China.
Front Pediatr. 2025 Aug 22;13:1660855. doi: 10.3389/fped.2025.1660855. eCollection 2025.
Femoral neck fractures are clinically rare and are associated with a high risk of complications in children. Traditional internal fixation implants such as Kirschner wires and partial-thread cannulated screws (PTCS) have complications such as screw withdrawal and internal fixation failure. To address this problem, in this study we investigated the effectiveness of headless cannulated compression screws (HCCS) in the treatment of femoral neck fractures in children patients.
Children diagnosed with Delbet-Colonna II or III femoral neck fracture treated by closed reduction and percutaneous fixation with HCCS were retrospectively reviewed. The extent of fracture reduction and postoperative hip function were assessed according to the Haidukewych standard and with the Harris score, respectively. Postoperative complications were recorded.
According to the inclusion criteria and exclusion criteria in this retrospective study, A total of 12 patients (8 males and 4 females) aged 3-14 years (average age: 8.3 years) were reviewed. The mean blood loss from surgery was 34.58 ± 9.40 ml and mean operation time was 102.50 ± 32.72 min. Overall, fracture reduction was achieved in most cases, with 7 that were excellent (58.33%) and 5 that were good (41.67%) according to the Haidukewych standard. The average follow-up period was 24.67 months. Radiographic analysis revealed an average time for fracture healing of 8.58 ± 3.87 weeks. Harris score was 88.67 ± 2.61 at 3 months after surgery, and increased to 92.25 ± 1.91 at the 6-month follow-up; excellent outcomes were achieved at the last follow-up evaluation (95.17 ± 1.95). No surgery-related complications were reported during the follow-up period.
We recommend closed reduction and internal fixation with HCCS as a feasible alternative for the treatment of Delbet-Colonna II and III femoral neck fractures in children.
儿童股骨颈骨折临床少见且并发症风险高。克氏针和部分螺纹空心螺钉（PTCS）等传统内固定植入物存在螺钉退出和内固定失败等并发症。为解决这一问题，本研究探讨了无头空心加压螺钉（HCCS）治疗儿童股骨颈骨折的有效性。
回顾性分析采用闭合复位经皮HCCS固定治疗的Delbet-Colonna II或III型儿童股骨颈骨折患者。分别根据海杜克维奇标准和Harris评分评估骨折复位程度和术后髋关节功能。记录术后并发症。
根据本回顾性研究的纳入标准和排除标准，共纳入12例年龄3至14岁（平均年龄：8.3岁）的患者（8例男性，4例女性）。手术平均失血量为34.58±9.40 ml，平均手术时间为102.50±32.72 min。总体而言，大多数病例实现了骨折复位，根据海杜克维奇标准，7例为优（58.33%），5例为良（41.67%）。平均随访期为24.67个月。影像学分析显示骨折愈合平均时间为8.58±3.87周。术后3个月Harris评分为88.67±2.61，6个月随访时增至92.25±1.91；末次随访评估时达到优良结果（95.17±1.95）。随访期间未报告与手术相关的并发症。
我们推荐闭合复位HCCS内固定作为治疗儿童Delbet-Colonna II和III型股骨颈骨折的可行替代方法。
