Post-traumatic Coxa Vara in Children Following Screw Fixation of the Femoral Neck

Overview

Journal Acta Orthop

Specialty Orthopedics

Date 2010 Sep 3

PMID 20809743

Citations 12

Authors

Robert Eberl

Georg Singer

Peter Ferlic

Annelie M Weinberg

Michael E Hoellwarth

Affiliations

Soon will be listed here.

Abstract

Background And Purpose: The rare displaced fractures of the femoral neck in children need accurate reduction and rigid fixation. The implants commonly used for internal fixation in children are pins or screws. We evaluated the long-term outcome in children who sustained fractures of the proximal femur that were treated by screw fixation.

Patients And Methods: All 22 children (mean age 12 (5-16) years) with fractures of the femoral neck that were treated with screw fixation (mean 2.4 (1-3) screws) at our department between 1990 and 2006 were evaluated. For measurement of outcome, the Harris hip score (HHS) was used and the development of post-traumatic coxa vara was assessed from the difference in the neck-shaft angle postoperatively and at the latest follow-up examination, after mean 4 (2-15) years.

Results: A loss of reduction was observed in 12 patients. There was a statistically significant correlation between the HHS and the changes in the neck-shaft angle.

Interpretation: Loss of reduction was found in more than half of the children. Screw fixation cannot be recommended for the treatment of femoral neck fractures in children due to a substantial number of post-traumatic coxa vara.

Citing Articles

Management of pediatric femoral neck fractures from classification to surgery: a review of indications based on anatomic and radiographic features of the proximal femur.

Wang W, Canavese F, Xiong Z, Tang S, Chen S, He S EFORT Open Rev. 2025; 10(3):125-140.

PMID: 40071987 PMC: 11896687. DOI: 10.1530/EOR-2024-0129.

Open reduction versus closed reduction in internal fixation of displaced femoral neck fracture in children: a systematic review and meta-analysis.

Lim E, Kim B, Kim M, Shon H, Kim C J Orthop Surg Res. 2023; 18(1):49.

PMID: 36650541 PMC: 9843841. DOI: 10.1186/s13018-023-03525-x.

Do the Number, Size, and Position of Partially Threaded Screws Affect the Radiological Healing of Surgically Treated Displaced Femoral Neck Fractures? A Review of 136 Children.

Wang W, Xiong Z, Zhao C, He B, Mei H, Li Y Medicina (Kaunas). 2022; 58(9).

PMID: 36143830 PMC: 9504257. DOI: 10.3390/medicina58091153.

Controversies in the management of pediatric neck femur fractures- a systematic review.

Chandankere V, Shah H J Orthop. 2021; 27:92-102.

PMID: 34588744 PMC: 8453205. DOI: 10.1016/j.jor.2021.08.014.

Risk Factors for Avascular Necrosis of the Femoral Head in Pediatric Femoral Neck Fractures.

Chaudhary S, Garg V, Mishra D, Yasam R, Barik S, Sinha S Cureus. 2021; 13(7):e16776.

PMID: 34476143 PMC: 8404535. DOI: 10.7759/cureus.16776.

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