Logo of The Journal of Bone & Joint Surgery (Br)
Quick search:        
          Advanced Search
Guest Access | Sign In
Journal of Bone and Joint Surgery - British Volume, Vol 84-B, Issue 1, 108-112.
doi: 10.1302/0301-620X.84B1.11972  
Copyright © 2002 by British Editorial Society of Bone and Joint Surgery
This Article
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow My Folders
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Flynn, J. M.
Right arrow Articles by Davidson, R. S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Flynn, J. M.
Right arrow Articles by Davidson, R. S.

Displaced fractures of the hip in children

MANAGEMENT BY EARLY OPERATION AND IMMOBILISATION IN A HIP SPICA CAST

J. M. Flynn, MD, Staff Orthopaedic Surgeon1; K. L. Wong, MD, Postgraduate Year 4 Resident2; G. L. Yeh, MD, Postgraduate Year 4 Resident2; J. S. Meyer, MD, Radiologist3; and R. S. Davidson, MD, Staff Orthopaedic Surgeon1

1 Division of Orthopaedic Surgery
2 Department of Orthopaedic Surgery, Hospitals of the University of Pennsylvania, Silverstein Building, Second Floor, 3400 Spruce Street, Philadelphia, Pennsylvania 19104, USA.
3 Department of Radiology, The Children’s Hospital of Philadelphia, 2 Wood Centre, 34th Street and Civic Centre Boulevard, Philadelphia, Pennsylvania 19104, USA

Fractures of the hip in children have been associated with a very high rate of serious complications including avascular necrosis (up to 47%) and coxa vara (up to 32%). Over a period of 20 years, we have treated displaced fractures by early anatomical reduction, internal fixation and immobilisation in a spica cast to try to reduce these complications.

We have reviewed 18 patients who had a displaced non-pathological fracture of the hip when under 16 years of age. Their mean age at the time of the injury was eight years (2 to 13). They returned for examination and radiography at a mean follow-up of eight years (2 to 17). Each patient had been treated by early (''24 hours) closed or open reduction with internal fixation and 16 had immobilisation in a spica cast.

By Delbet’s classification, there was one type-I, eight type-II, eight type-III, and one type-IV fractures. There were no complications in 15 patients. Avascular necrosis occurred in one patient (type-III), nonunion in one (type-II, one of the two patients who did not have a cast) and premature physeal closure in one (type-I). There were no cases of infection or complications as a result of the cast.

Our treatment of displaced hip fractures in children by early reduction, internal fixation, and immobilisation in a spica cast gave reduced rates of complications compared with that of large published series in the literature.






(c) British Editorial Society of Bone and Joint Surgery All Rights Reserved
Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General