Femoral neck fracture in children

The thigh bone (femur) is the strongest bone in the human body, and therefore breaks in healthy young people only in the case of strong violence, such as a fall from a great height. Due to generally better healing processes in children, conservative therapies can be justified far more often in children than in adults. Especially in children under 2 years of age, fractures heal very quickly.

For example, immobilisation of an uncomplicated fracture using a pelvic-leg cast is usually possible in infants and small children.Complete healing of the injury takes about 3-4 weeks. However, more complicated fractures usually require surgery. These include fractures involving the pineal gland (growth plate).

In the long term, this can lead to growth inhibition or malpositioning of the leg, which is why regular follow-up care at intervals of usually one month is necessary in addition to surgery. A number of surgical procedures are available, especially for children. Among others, the external fixator or the elastically stable intramedullary nailing (ESIN) is frequently used. Compared to conservative therapy, surgery generally allows the child to regain weight-bearing on the leg earlier. This is done under increasing load during physiotherapy.

Prognosis

The blood supply to the femoral head is crucial for the prognosis of a femoral neck fracture. If this blood supply is interrupted and cannot be restored, there is a high risk of femoral head necrosis. The femoral head dies because it is no longer nourished and thus loses its function.

In these cases the femoral head must be replaced by a prosthesis. However, if the femoral neck fracture is treated quickly and efficiently, the prognosis is relatively good. Nevertheless, patients should be aware that the mobility after a femoral neck fracture usually no longer corresponds to the mobility in the period before the accident.

Very old patients in particular often have difficulty recovering and moving after the operation. For this reason, there is a very high mortality rate among old people within the first few years, due to complications caused by bedriddenness. These consist mainly of pneumonia or thrombosis with pulmonary embolism.