Schärli A F, Osterwalder M, Winiker H
Kinderchirurgische Klinik, Kinderspital Luzern.
Helv Chir Acta. 1993 Jun;59(5-6):999-1009.
Femoral neck fractures during childhood are very rare. Up to 60% complications have to be expected due to the special epiphyseal development and vascularization, i.e. necroses of the femoral head, pseudarthroses and growth disturbances. Only undislocated fractures are treated conservatively in a plaster cast. The end result may be improved with early reposition and operative treatment. The outlook of our own 16 cases using this procedure was considerably better than in the current literature. The preferred technique consists of stabilizing the fracture with a cannulated screw and two K-wires to prevent rotation. For pertrochanteric, mostly pathologic fractures, a T-plate in conjunction with cannulated screws and transplantation of homologous spongiosa has proved successful.