![]() It was first placed in the receiver with normal saline so that its viability would not be compromised. The epiphyseal portion of the femoral head was completely detached and was located in the soft tissue. For better exposure to the hip joint, short external rotators were incised. Gluteal muscle was dissected and sciatic nerve explored. Īfter a failed closed reduction, the patient was placed in a lateral decubitus position for ORIF with a posterolateral approach. AVN is more common in type I of Delbet classification and almost not seen in type IV. ![]() Among all the complications, AVN is more common, which can be justified by the blood supply of the femoral head. Avascular necrosis (AVN), premature physeal closure, coxa vara, nonunion, and infection are some consequences that should be considered. Beside the main injury, what worries orthopedic specialists about femoral neck fractures are the complications of this lesion. Due to the importance of this classification on the prognosis of the lesion, it is important to pay attention to it. Type II, III, IV, and finally I are more common, respectively. Type II is transcervical type III is basicervical and type IV is intertrochanteric. Type I is transepiphyseal that is divided into two types A (undisplaced) and B (displaced). Femoral neck fractures in children are divided into four types according to Delbet classification. Unlike children, femoral neck fractures because of low-energy trauma are common in adults. Other causes of femoral neck fracture such as pathological fractures due to low-energy trauma and stress fractures following jumping or running are very rare. This injury is a rare condition that often occurs following high-energy traumas such as vehicles accident, fall from height, and severe injuries. After 8 months of follow-up, AVN was noticed.Ībout 1% of all fractures in pediatrics are related to femoral neck fractures. The reduction was maintained with guide pins and fixed with cannulated screws. After one failed attempt to closed reduction, open reduction and internal fixation with a posterolateral (Kocher) approach was performed under general anesthesia. Here, we report a 14-year-old boy who was brought to the emergency department with a Delbet type 1B fracture of the left femoral neck with detached epiphyseal portion of the femoral head due to a car accident. Due to the high probability of complications and the urgent need for treatment of femoral neck fracture, early intervention and timely treatment should be performed. Therapeutic action for these patients is close or open reduction with internal fixation under general anesthesia, which according to the evidences, open reduction is a more successful method. ![]() Among the classifications of femoral neck fractures, which are known as the Delbet classification, type 1 is the least common but with the highest risk of AVN. The high risk of complications, such as avascular necrosis (AVN), which is the most common and serious complication, coxa vara, nonunion, premature physeal closure and infections, turns this fracture into an orthopedic emergency and increases the need for early treatment and intervention. Among all pediatric fractures, femoral neck fracture is an infrequent injury that occurs due to high-energy trauma.
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