Bilateral Fracture Neck Femur in Child with Bilateral Delayed Union and Bilateral AVN: A Rare Occurrence and Literature Review

Overview

Journal Indian J Orthop

Publisher Springer Nature

Specialty Orthopedics

Date 2021 Jul 26

PMID 34306567

Citations 1

Authors

Premal Naik

Nihit Mantri

Parag Tank

Ravi Bhesaniya

Affiliations

Soon will be listed here.

Abstract

A bilateral neck of femur fracture in children is a rare occurrence with only twelve cases reported till the date. We report a case of a 3-year-old schoolgirl with bilateral Delbet type 2 fracture neck femur after a fall from height. She was managed elsewhere by bilateral closed reduction and screw fixation within 24 h. She presented to us three months after surgery with painful hip movements and inability to walk. Her X-ray showed bilateral Ratliff type three avascular necrosis and bilateral delayed union with visible fracture lines. We placed her in double hip spica for three months. Fortunately, on both sides fractures united well with complete resolution of avascular changes. At one year follow-up, she had no functional limitation, no limb length discrepancy, and an x-ray showed mild coxa vara on left. Bilateral delayed union and avascular necrosis of fracture neck femur has not been reported till date.

Citing Articles

Bilateral Non-traumatic Neglected Femoral Neck Fracture in a Healthy Adolescent: A Case Report and Review of Literature.

Pandey R, Garg L J Orthop Case Rep. 2023; 13(10):105-110.

PMID: 37885626 PMC: 10599381. DOI: 10.13107/jocr.2023.v13.i10.3954.

References

Gilban H, Mirdad T, Jenyo M . Simultaneous post traumatic bilateral cervico-trochanteric femoral neck fractures in a child: a case report. West Afr J Med. 2006; 24(4):348-9. DOI: 10.4314/wajm.v24i4.28235. View

Dhar D . Bilateral traumatic fracture of neck of femur in a child: a case report. Malays Orthop J. 2015; 7(2):34-6. PMC: 4341036. DOI: 10.5704/MOJ.1307.001. View

Papanna M, Tafazal S, Bell M, Giles S, Fernandes J . Femoral neck fractures in osteogenesis imperfecta treated with bisphosphonates. J Child Orthop. 2017; 11(3):191-194. PMC: 5548034. DOI: 10.1302/1863-2548.11.160212. View

Moon E, Mehlman C . Risk factors for avascular necrosis after femoral neck fractures in children: 25 Cincinnati cases and meta-analysis of 360 cases. J Orthop Trauma. 2006; 20(5):323-9. DOI: 10.1097/00005131-200605000-00005. View

Kozlowski K, Braune M, Scougall J . Multiple fractures in early infancy: report of two unusual cases. Rofo. 1980; 133(3):312-6. DOI: 10.1055/s-2008-1056733. View

Gopinathan N, Chouhan D, Akkina N, Behera P . Case report: Bilateral femoral neck fractures in a child and a rare complication of slipped capital epiphysis after internal fixation. Clin Orthop Relat Res. 2012; 470(10):2941-5. PMC: 3441978. DOI: 10.1007/s11999-012-2458-5. View

Togrul E, Bayram H, Gulsen M, Kalaci A, Ozbarlas S . Fractures of the femoral neck in children: long-term follow-up in 62 hip fractures. Injury. 2004; 36(1):123-30. DOI: 10.1016/j.injury.2004.04.010. View

Morrissy R . Hip fractures in children. Clin Orthop Relat Res. 1980; (152):202-10. View

Ratliff A . Fractures of the neck of the femur in children. J Bone Joint Surg Br. 1962; 44-B:528-42. DOI: 10.1302/0301-620X.44B3.528. View

10.

Dial B, Lark R . Pediatric proximal femur fractures. J Orthop. 2018; 15(2):529-535. PMC: 5909031. DOI: 10.1016/j.jor.2018.03.039. View

11.

Venkatadass K, Avinash M, Rajasekaran S . Bilateral avascular necrosis of the femoral head following asynchronous postictal femoral neck fractures: a case report and review of the literature. J Pediatr Orthop B. 2017; 27(3):274-278. DOI: 10.1097/BPB.0000000000000460. View

12.

Upadhyay A, Maini L, Batra S, Mishra P, Jain P . Simultaneous bilateral fractures of femoral neck in children--mechanism of injury. Injury. 2004; 35(10):1073-5. DOI: 10.1016/S0020-1383(03)00190-6. View

13.

Mazurek T, Lorczynski A, Ceynowa M . Bilateral femoral neck fracture in a child: a 17-year follow-up. J Pediatr Orthop B. 2011; 20(5):295-8. DOI: 10.1097/BPB.0b013e3283467232. View

14.

Canale S, Bourland W . Fracture of the neck and intertrochanteric region of the femur in children. J Bone Joint Surg Am. 1977; 59(4):431-43. View

15.

Scheerlinck T, De Boeck H . Bilateral stress fractures of the femoral neck complicated by unilateral displacement in a child. J Pediatr Orthop B. 1998; 7(3):246-8. DOI: 10.1097/01202412-199807000-00015. View

16.

Sanghavi S, Patwardhan S, Shyam A, Nagda T, Naik P . Nonunion in Pediatric Femoral Neck Fractures. J Bone Joint Surg Am. 2020; 102(11):1000-1010. DOI: 10.2106/JBJS.19.01117. View

17.

Yeranosian M, Horneff J, Baldwin K, Hosalkar H . Factors affecting the outcome of fractures of the femoral neck in children and adolescents: a systematic review. Bone Joint J. 2013; 95-B(1):135-42. DOI: 10.1302/0301-620X.95B1.30161. View

18.

Forlin E, Guille J, Kumar S, Rhee K . Complications associated with fracture of the neck of the femur in children. J Pediatr Orthop. 1992; 12(4):503-9. DOI: 10.1097/01241398-199207000-00017. View

19.

Chandankere V, Mulpur P, Maryada V, Pendyala S, Annapareddy G . Simultaneous bilateral neck of femur fractures in an adolescent secondary to hypocalcaemic seizure. J Pediatr Orthop B. 2018; 28(5):491-494. DOI: 10.1097/BPB.0000000000000560. View