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Case Report: Bilateral Femoral Neck Fractures in a Child and a Rare Complication of Slipped Capital Epiphysis After Internal Fixation.

Summary of "Case Report: Bilateral Femoral Neck Fractures in a Child and a Rare Complication of Slipped Capital Epiphysis After Internal Fixation."


BACKGROUND:
Bilateral traumatic femoral neck fractures are uncommon in children. The most commonly reported complications are nonunion, avascular necrosis of the femoral head, and chondrolysis. Slipped capital femoral epiphysis (SCFE) associated with nonunion after percutaneous partially threaded cancellous screw (PTCS) fixation of the fracture is an unreported complication. CASE
DESCRIPTION:
We describe a 10-year-old boy who had bilateral femoral neck fractures secondary to a fall from a height. The patient was treated with percutaneous PTCS fixation on both sides and achieved union on the right side in 3 months, however, a nonunion and SCFE developed on the left side 5 months after the initial surgery. Management of the nonunion and SCFE with PTCS and nonvascularized fibula graft led to union. Eighteen months after the initial injury, the patient achieved a pain and limp-free gait. LITERATURE
REVIEW:
A literature review shows avascular necrosis, posttraumatic coxa vara, premature physeal closure, nonunion, chondrolysis, infection, and implant failure as complications of operative management of femoral neck fractures. SCFE has not been previously reported. PURPOSES AND CLINICAL
RELEVANCE:
This case highlights the need for close followup of adolescent patients with PTCS fixation for femoral neck fractures.

Affiliation

Department of Orthopedics, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.

Journal Details

This article was published in the following journal.

Name: Clinical orthopaedics and related research
ISSN: 1528-1132
Pages:

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Medical and Biotech [MESH] Definitions

Fractures of the FEMUR HEAD; the FEMUR NECK; (FEMORAL NECK FRACTURES); the trochanters; or the inter- or subtrochanteric region. Excludes fractures of the acetabulum and fractures of the femoral shaft below the subtrochanteric region (FEMORAL FRACTURES).

Fractures of the short, constricted portion of the thigh bone between the femur head and the trochanters. It excludes intertrochanteric fractures which are HIP FRACTURES.

Fractures due to the strain caused by repetitive exercise. They are thought to arise from a combination of MUSCLE FATIGUE and bone failure, and occur in situations where BONE REMODELING predominates over repair. The most common sites of stress fractures are the METATARSUS; FIBULA; TIBIA; and FEMORAL NECK.

A groin hernia occurring inferior to the inguinal ligament and medial to the FEMORAL VEIN and FEMORAL ARTERY. The femoral hernia sac has a small neck but may enlarge considerably when it enters the subcutaneous tissue of the thigh. It is caused by defects in the ABDOMINAL WALL.

Metabolic disorder associated with fractures of the femoral neck, vertebrae, and distal forearm. It occurs commonly in women within 15-20 years after menopause, and is caused by factors associated with menopause including estrogen deficiency.

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