Analysis of risk factors for postoperative femoral head necrosis in children with femoral neck fractures

XIAO Yuan; LIU Xin; ZHOU Ying; YE Jia-jun; DENG Zhi-qiang; REN Bo

doi:10.11659/jjssx.09E023006

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Analysis of risk factors for postoperative femoral head necrosis in children with femoral neck fractures

Bone and Joint | 更新时间：2024-09-29

- Analysis of risk factors for postoperative femoral head necrosis in children with femoral neck fractures
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 33, Issue 9, Pages: 773-777(2024)
- 作者机构：
  
  四川省骨科医院儿童骨科，四川成都 610041
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.09E023006
  CLC： R683.42
- Published：25 September 2024，
  
  Received：01 September 2023，
- 稿件说明：
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肖元,刘昕,周英等.儿童股骨颈骨折术后股骨头坏死的危险因素分析[J].局解手术学杂志,2024,33(09):773-777.

XIAO Yuan,LIU Xin,ZHOU Ying,et al.Analysis of risk factors for postoperative femoral head necrosis in children with femoral neck fractures[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(09):773-777.
肖元,刘昕,周英等.儿童股骨颈骨折术后股骨头坏死的危险因素分析[J].局解手术学杂志,2024,33(09):773-777. DOI： 10.11659/jjssx.09E023006.

XIAO Yuan,LIU Xin,ZHOU Ying,et al.Analysis of risk factors for postoperative femoral head necrosis in children with femoral neck fractures[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(09):773-777. DOI： 10.11659/jjssx.09E023006.

摘要

目的

探讨导致儿童股骨颈骨折术后股骨头坏死的独立危险因素。

方法

回顾性分析2008年7月至2021年7月在我院接受手术治疗的122例股骨颈骨折患儿的临床资料，统计股骨头坏死情况，并根据是否出现股骨头坏死将患儿分为股骨头坏死组和股骨头正常组，分析导致股骨头坏死的危险因素。

结果

122例患儿中有22例（18.03%）出现股骨头坏死，儿童股骨颈骨折术后出现股骨头坏死可能与患儿年龄、Delbet分型、初始移位程度、受伤机制、手术时间、内固定方式及复位质量有关（

0.05），但与患儿性别、侧别、受伤至手术时间、复位方式无显著相关性（

0.05）。

Logistic

回归分析结果显示，年龄大于10岁、Delbet Ⅰ~Ⅱ型、初始移位程度为Ⅲ型、高能量损伤及不可接受复位均为儿童股骨颈骨折术后股骨头坏死的独立危险因素（

0.05）。

结论

大龄儿童、Delbet Ⅰ~Ⅱ型、初始移位程度大、高能量损伤及不可接受复位是儿童股骨颈骨折术后股骨头坏死的独立危险因素。

Abstract

Objective

To investigate the independent risk factors of postoperative femoral head necrosis for pediatric femoral neck fractures.

Methods

The clinical data of 122 children with femoral neck fracture who underwent surgery in our hospital from July 2008 to July 2021 were retrospectively analyzed. The femoral head necrosis was counted， and the children were divided into the femoral head necrosis group and the femoral head normal group according to the presence of femoral head necrosis， then the risk factors of femoral head necrosis were analyzed.

Results

Of the 122 children， 22 cases （18.03%） had femoral head necrosis. The postoperative femoral head necrosis for pediatric femoral neck fractures may be related to the age， Delbet classification， initial displacement degree， injury mechanism， operation time， internal fixation method and reduction quality （

0.05）， while which has no significant correlation with the gender， side， time from injury to operation， or reduction method （

0.05）. The results of

Logistic

regression analysis showed that age

10 years， Delbet type of Ⅰ to Ⅱ， initial displacement degree of type Ⅲ， high-energy injury and unacceptable reduction were the independent risk factors of postoperative femoral head necrosis for pediatric femoral neck fractures （

0.05）.

Conclusion

Older children， or patients with Delbet type of Ⅰ to Ⅱ， large degree of initial displacement， high-energy injury， and unacceptable reduction are the independent risk factors of postoperative femoral head necrosis for pediatric femoral neck fractures.

关键词

儿童股骨颈骨折股骨头坏死切开复位闭合复位

Keywords

childrenfemoral neck fracturesfemoral head necrosisopen reductionclosed reduction

references

Xin P，Tu Y，Hong Z，et al.The clinical and radiographic characteristics of avascular necrosis after pediatric femoral neck fracture： a systematic review and retrospective study of 115 patients［J］.J Orthop Surg Res，2020，15（1）：520.doi：10.1186/s13018-020-02037-2http://dx.doi.org/10.1186/s13018-020-02037-2.

Patterson JT，Tangtiphaiboontana J，Pandya NK.Management of pediatric femoral neck fracture［J］.J Am Acad Orthop Surg，2018，26（12）：411-419.doi：10.5435/JAAOS-D-16-00362http://dx.doi.org/10.5435/JAAOS-D-16-00362.

Bali K，Sudesh P，Patel S，et al.Pediatric femoral neck fractures： our 10 years of experience［J］.Clin Orthop Surg，2011，3（4）：302-308.doi：10.4055/cios.2011.3.4.302http://dx.doi.org/10.4055/cios.2011.3.4.302.

Yeranosian M，Horneff JG，Baldwin K，et al.Factors affecting the outcome of fractures of the femoral neck in children and adolescents： a systematic review［J］.Bone Joint J，2013，95-B（1）：135-142.doi：10.1302/0301-620X.95B1.30161http://dx.doi.org/10.1302/0301-620X.95B1.30161.

Wang WT，Li YQ，Guo YM，et al.Risk factors for the development of avascular necrosis after femoral neck fractures in children： a review of 239 cases［J］.Bone Joint J，2019，101-B（9）：1160-1167.doi：10.1302/0301-620X.101B9.BJJ-2019-0275.R1http://dx.doi.org/10.1302/0301-620X.101B9.BJJ-2019-0275.R1.

Song KS.Displaced fracture of the femoral neck in children： open versus closed reduction［J］.J Bone Joint Surg Br，2010，92（8）：1148-1151.doi：10.1302/0301-620X.92B8.24482http://dx.doi.org/10.1302/0301-620X.92B8.24482.

Colonna PC.Fracture of the neck of the femur in children［J］.Am J Surg，1929，6：793-797.

Spence D，DiMauro JP，Miller PE，et al.Osteonecrosis after femoral neck fractures in children and adolescents： analysis of riskfactors［J］.J Pediatr Orthop，2016，36（2）：111-116.doi：10.1097/BPO.00000 00000000424http://dx.doi.org/10.1097/BPO.0000000000000424.

JrRiley PM，Morscher MA，Gothard MD，et al.Earlier time to reduction did not reduce rates of femoral head osteonecrosis in pediatric hip fractures［J］.J Orthop Trauma，2015，29（5）：231-238.doi：10.1097/BOT.0000000000000226http://dx.doi.org/10.1097/BOT.0000000000000226.

Trueta J.The normal vascular anatomy of the human femoral head during growth［J］.J Bone Joint Surg Br，1957，39-B（2）：358-394.doi：10.1302/0301-620X.39B2.358http://dx.doi.org/10.1302/0301-620X.39B2.358.

Ogden JA.Changing patterns of proximal femoral vascularity［J］.J Bone Joint Surg Am，1974，56（5）：941-950.

Fletcher ND，Schiller JR，Garg S，et al.Increased severity of type Ⅲ supracondylar humerus fractures in the preteen population［J］.J Pediatr Orthop，2012，32（6）：567-572.doi：10.1097/BPO.0b013e31824b542dhttp://dx.doi.org/10.1097/BPO.0b013e31824b542d.

Farnsworth CL，Silva PD，Mubarak SJ.Etiology of supracondylar humerus fractures［J］.J Pediatr Orthop，1998，18：38-42.

Moon ES，Mehlman CT.Risk factors for avascular necrosis after femoral neck fractures in children： 25 Cincinnati cases and meta-analysis of 360 cases［J］.J Orthop Trauma，2006，20（5）：323-329.doi：10.1097/00005131-200605000-000054http://dx.doi.org/10.1097/00005131-200605000-000054.

Quick TJ，Eastwood DM.Pediatric fractures and dislocations of the hip and pelvis［J］.Clin Orthop Relat Res，2005（432）：87-96.doi：10.1097/01.blo.0000155372.65446.40http://dx.doi.org/10.1097/01.blo.0000155372.65446.40.

Swiontkowski MF，Winquist RA.Displaced hip fractures in children and adolescents［J］.J Trauma，1986，26（4）：384-388.doi：10.1097/00005373-198604000-00013http://dx.doi.org/10.1097/00005373-198604000-00013.

Inan U，Köse N，Omeroğlu H.Pediatric femur neck fractures： a retrospective analysis of 39 hips［J］.J Child Orthop，2009，3（4）：259-264.doi：10.1007/s11832-009-0180-yhttp://dx.doi.org/10.1007/s11832-009-0180-y.

Morsy HA.Complications of fracture of the neck of the femur in children.A long-term follow-up study［J］.Injury，2001，32（1）：45-51.doi：10.1016/s0020-1383（00）00109-1http://dx.doi.org/10.1016/s0020-1383（00）00109-1.

AlKhatib N，Younis MH，Hegazy A，et al.Early versus late treatment of paediatric femoral neck fractures： a systematic review and meta-analysis［J］.Int Orthop，2019，43（3）：677-685.doi：10.1007/s00264-018-3998-4http://dx.doi.org/10.1007/s00264-018-3998-4.

Ng GP，Cole WG.Effect of early hip decompression on the frequency of avascular necrosis in children with fractures of the neck of the femur［J］.Injury，1996，27（6）：419-421.doi：10.1016/0020-1383（96）00025-3http://dx.doi.org/10.1016/0020-1383（96）00025-3.

Stone JD，Hill MK，Pan Z，et al.Open reduction of pediatric femoral neck fractures reduces osteonecrosis risk［J］.Orthopedics，2015，38（11）：e983-e990.doi：10.3928/01477447-20151020-06http://dx.doi.org/10.3928/01477447-20151020-06.

Varshney MK，Kumar A，Khan SA，et al.Functional and radiological outcome after delayed fixation of femoral neck fractures in pediatric patients［J］.J Orthop Traumatol，2009，10（4）：211-216.doi：10.1007/ s10195-009-0072-4http://dx.doi.org/10.1007/s10195-009-0072-4.

Dendane MA，Amrani A，El Alami ZF，et al.Displaced femoral neck fractures in children：are complications predictable？［J］.Orthop Traumatol Surg Res，2010，96（2）：161-165.doi：10.1016/j.rcot.2010.02.004http://dx.doi.org/10.1016/j.rcot.2010.02.004.

Bukva B，Abramović D，Vrgoč G，et al.Femoral neck fractures in children and the role of early hip decompression in final outcome［J］.Injury，2015，46（Suppl 6）：S44-S47.doi：10.1016/j.injury. 2015. 10.059http://dx.doi.org/10.1016/j.injury.2015.10.059.

汪文涛，陈顺有.儿童股骨颈骨折的治疗：闭合复位还是开放复位？［J］.临床小儿外科杂志，2020，19（7）：561-564.

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