Skeletal Radiol 18:445–449īoytim MJ, Davidson RS, Charney E, Melchionni JB (1991) Neonatal fractures in myelomeningocele patients. Vieco PT, Azouz EM, Hoeffel JC (1989) Metastases to bone in medulloblastoma. Williams & Wilkins, Baltimore, pp 530–532 In: Reed MH (ed) Pediatric skeletal radiology. J Bone Joint Surg 70:1422–1427ĭavison BL, Weinstein SL (1992) Hip fractures in children: a long-term follow-up study. Can Med Assoc J 129:595–597Ĭrawford AH (1988) Slipped capital femoral epiphysis. Orthopedics 12:361–367Īzouz EM (1983) Apparent or true neonatal hip dislocation? Radiologic differential diagnosis. Ovesen O, Arreskov J, Bellstrøm T (1989) Hip fractures in children. J Bone Joint Surg 53:1165–1179Ĭanale ST, Bourland WL (1977) Fracture of the neck and intertrochanteric region of the femur in children. Lam SF (1971) Fractures of the neck of the femur in children. Springer, Berlin, pp 14–16īarquet A, Vécsei V (1984) Traumatic dislocation of the hip with separation of the proximal femoral epiphysis. Philadelphia, pp 339–346īarquet A (1987) Traumatic hip dislocation in childhood. J Trauma 26:384–388Ĭhung SMK (1981) Hip disorders in infants and children. Swiontkowski MF, Winquist RA (1986) Displaced hip fractures in children and adolescents. Morrissy R (1980) Hip fractures in children. These fractures are rare, but are serious injuries since their complications may lead to a life-long disability.Ĭolonna PC (1929) Fractures of the neck of the femur in children. an underlying bone lesion or a metabolic bone disease. Unless there is a clear history of significant violence, a cause for a femoral neck fracture should be sought, e. Complications included avascular necrosis 13%, premature closure of the epiphyseal plate 12%, varus deformity 8.3%, and nonunion 3.7%. Because of the unique osseous and vascular anatomy of the femoral head and neck in the growing child, these fractures have a high incidence of complications. Osteoporosis as in myelodysplasia, osteogenesis imperfecta and from other causes was responsible for 52% of insufficiency fractures. A unicameral bone cyst was the underlying lesion in 40% of pathologic femoral neck fractures and malignancy in 35%. ![]() Unless the underlying bone was abnormal, significant high velocity trauma, fall from a height or other severe violence was required to fracture the femoral neck. Forty-nine fractures were traumatic 37 were pathologic, 19 were insufficiency fractures and three were fatique fractures. Fractures occurred at all ages (one day to 18 years), and 63% of the patients were boys. Cases originated from four different pediatric hospitals. ![]() It is a retrospective clinical and radiological review of 108 femoral neck fractures. See Instructions for Authors for a complete description of levels of evidence.This multicenter collaborative study was undertaken to review the types and complications of femoral neck fractures in children. This relationship may guide early treatment decisions, suggesting that 3- and 6-month RUSH are a useful surrogate measure of reoperations within 24 months of fracture fixation. CONCLUSIONS: Decreased radiographic healing as early as 3 months post fracture fixation is associated with developing patient important femoral neck fracture reoperations. A similar association was observed at the 6-month assessment for every 2-point decrease (OR = 1.05 95% CI, 1.01-1.09 P = 0.005). For every 2-point decrease in RUSH at 3 months, there was a 16% increase in the odds of a patient experiencing a re-operation (OR, 1.16 95% CI, 1.10-1.22 P < 0.0001). RESULTS: Lower RUSH at 3 and 6 months were associated with increased odds of reoperation within 24 months of fracture fixation. MAIN OUTCOME MEASURES: Revision surgery rate related to intervention. INTERVENTION: A reviewer blinded to patients' outcomes independently assigned a RUSH at each follow-up time point. PATIENTS/PARTICIPANTS: Data from 734 of the clinical trial participants with radiographs at 3 and 6 months after fracture fixation were included. SETTING: Eighty-one clinical sites across 8 countries. All tests were 2 tailed with alpha = 0.05. Results were reported as odds ratios (OR), 95% confidence intervals (CIs), and associated P values. ![]() Logistic regression was performed to investigate associations between lower RUSH and reoperation. DESIGN: Secondary analysis of a randomized controlled trial. OBJECTIVES: To determine if the Radiographic Union Score for Hip (RUSH) measured at 3 and 6 months after femoral neck fracture were predictive of reoperation for infection, nonunion, delayed union, avascular necrosis, or implant failure within 24 months of initial surgery.
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