Official Journal of the Italian Society of Orthopaedics and Traumatology
Case | CaseAuthor | Age (years)/ sex | Side | Mode of injury | Femoral neck fx | Shaft fracture | Associated injuries | Management | Union (months) | Coxa vara | Avascular necrosis | Follow-up (months) | Result |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | Present series (case 1) | 8/F | Left | Road crash | Cervicotrochanteric (Delbet type III; AO type II) | Sub trochanteric | 1 screw & 3 Kirshner wires for the neck fracture, 5-hole plate and 3 screws for the shaft fracture | 4 | No | No | 52 | Good Ratliff score. Clinically good with a 10° varus deformity at the subtrochanteric level in the femur | |
2 | Present series (case 2) | 8/M | Right | Road crash | Intertrochanteric (Delbet type IV; AO type II) | Distal third | Lateral condyle fracture of the right humerus, distal radius fracture of left wrist fx, subdural hemorrhage of brain, ipsilateral sciatic nerve palsy (peroneal division) | 2 screws for the neck fracture, 6-hole plate and screws for the shaft fracture | 3 | Yes | No | 25 | Good Ratliff score. Clinically good except for only a slightly short neck and a 1.5 cm leg length discrepancy |
3 | Akahane | 2/F | Right | Road crash | Transepiphyseal (Delbet type Ib; AO epiphyseal type 1) | Distal third | Open reduction and internal fixation with 2 smooth Kirshner wires for neck fracture, hip spica cast. A-frame orthosis for the capital epiphysis | 1.5 | Yes | Yes (mild) | 24 | Clinically good, with some coxa vara and premature physeal closure of the medial segent at the 2-year follow-up | |
4 | Cannon | 2/F | Left | Fall from height | Transepiphyseal (Delbet type Ia; AO epiphyseal type I) | Midshaft | Closed reduction and hip spica cast for the neck fracture, and 4-hole plate screws for the shaft fracture | 2 | No | No | 12 | Excellent, except for some coxa vara | |
5 | Schwarz | 10/M | Right | Cervicotrochanteric (Delbet type III; AO type II) | Distal epiphyseal | 1 screw and 2 pins for the neck fracture on day 23, conservative for the distal physeal fracture | No comment | Yes | Yes (severe) | 188 | Aspherical head, coxa vara, short femoral neck, reversed articulotrochantric distance. Valgus and recurvatum deformity of the distal femur |